Orbital cavernous venous malformation
History of 1cm lesion in the orbit 3 years ago. Asymptomatic. Previous imaging studies not available for direct comparison.
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A 14 x 8 x 7mm sized intraconal well-circumscribed mass in the left orbit, with heterogeneous enhancement (1 minute post-injection scan).
No inflammatory changes in surrounding retrobulbar fat.
No abnormality of extraocular muscles or optic nerve sheath complex.
Cavernous venous malformations, previously known as cavernous hemangioma are the most common vascular orbital lesion in adults.
The diagnosis of cavernous angioma has been presumed in this case because of its well-defined morphology, intraconal location, lack of involvement of optic nerve sheath complex and extraocular muscles, lack of symptoms and relative stability over 3 years. MRI correlation is helpful, and stable asymptomatic lesions can be safely monitored with imaging.
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