Presentation
Periorbital soft painless vascular lesion.
Patient Data
MRI shows periorbital hyperintense T2 mass with multiple flow voids and homogenous enhancement post Gadolinium. The lesion is mostly pre-septal but is has a post-septal, extra-conal component at the superior portion of the orbit. The ipsilateral orbit has deviated inferiorly, but otherwise normal.
Brain parenchyma is normal. There is no other vascular anomaly on this MRI. Hence, it is compatible with infantile hemangioma of the orbit.
Case Discussion
The principal differential diagnosis, in this case, would be rhabdomyosarcoma, since other arteriovenous malformations would be highly unlikely, but a more heterogenous enhancement would be expected. Also, the age of the patient and location of the lesion makes this diagnosis a lot less plausible.
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