Cavernous hemangiomas of the orbit

Patients with cavernous hemangioma of the orbit seen at the Wills Eye Hospital for the 10-year period, 1972-1981 were reviewed in a retrospective manner. This benign vascular tumor most typically presented as unilateral painless proptosis in a middle-aged woman. The duration of symptoms was between 6 months and 2 years. CT scanning demonstrated a well-circumscribed, homogeneous tumor without bony erosion. Ultrasonography typically showed good sound transmission with moderate internal reflectivity. It is not possible to distinguish clinically a benign cavernous hemangioma from the rare and potentially lethal hemangiopericytoma. Since recurrence and metastasis of hemangiopericytoma may be related to incomplete excision, fastidious dissection and removal of all tumors thought to be cavernous hemangioma before surgery is advised for fear the final pathology may indicate hemangiopericytoma.