Orbital lymphatic malformation

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Left exophthalmos

Patient Data

Age: 25 years
Gender: Male

The MRI sequences demonstrate a left axial proptosis grade 2 with poorly marginated, multiloculated orbital cystic mass of intra and extraconal location of intermediate signal on T1 with areas of high signal, and heterogeneous high signal T2 with multiple fluid-fluid levels well-visualized on axial and coronal T2 fat sat sequences, corresponding to hemorrhagic, lymphatic, or proteinaceous content within the cystic spaces. The postcontrast sequences reveal a heterogeneous enhancement mainly of the margins of the cystic spaces.

Case Discussion

MRI features characteristic of an orbital lymphatic malformation.

Orbital lymphatic malformation is considered as a congenital benign vascular malformation with variable lymphatic and venous components.

The differential diagnosis should include mainly:

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