Presentation
Left proptosis
Patient Data
CT brain with contrast (arterial phase) shows a well-defined homogeneous left orbital intraconal mass lesion with a peripheral focus of enhancement. It results in mild left proptosis.
A well-circumscribed rounded orbital mass lesion is noted in retrobulbar intraconal region, superomedial to the optic nerve. It shows a homogeneous isointense signal on T1 and high signal on T2 with a low signal pseudocapsule and homogeneous post-contrast enhancement. It is indenting the medial aspect optic nerve and posterior scleral aspect resulting in mild proptosis. Normal surrounding extraocular muscles and orbital fat.
Case Discussion
Cavernous venous malformations of the orbit (cavernous haemangiomas) are the most common vascular lesion of the orbit in adults. Enhancement is usually gradual as seen while imaging post-contrast planes on MRI, the axial sequence shows peripheral enhancement mainly at the superior part as shown in CT while the sagittal sequence shows near complete homogeneous enhancement.
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