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Primary adnexal angiosarcoma masquerading as periorbital hematoma
Nicole Lemanski1, Martha Farber1, Bryant P Carruth1
1Ophthalmic Plastic Surgery, Department of Ophthalmology, Lions Eye Institute, Albany Medical College, Albany, NY, USA.
Survey of Ophthalmology
|December 3, 2014
Summary
An elderly anticoagulated woman with periorbital swelling initially diagnosed as trauma-related was found to have angiosarcoma. This case highlights the importance of considering malignancy in persistent periorbital swelling, even after trauma.
Area of Science:
- Oncology
- Ophthalmology
- Pathology
Background:
- Anticoagulated elderly patient presented with right orbital contusion and periorbital hematoma.
- Initial presentation lacked clinical or radiological signs of focal mass or orbital involvement.
- Conservative management was initially pursued.
Observation:
- Continued progression of adnexal swelling and erythema despite conservative treatment.
- Surgical drainage provided no improvement.
- Biopsy was performed due to persistent symptoms.
Findings:
- Biopsy revealed angiosarcoma, a rare vascular tumor.
- The tumor was not initially suspected due to trauma history and lack of typical mass presentation.
Implications:
- Underscores the need to reconsider diagnoses when findings are counterintuitive.
- Emphasizes considering malignancy in the differential diagnosis of prolonged periorbital swelling.
- Highlights the importance of thorough investigation regardless of apparent trauma history.
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