Orbital venous malformation

Case contributed by Frank Gaillard

The mass initially fills in posteriorly as contrast sinks dependently, and enlarges on later scan obtained with Valsalva. It has a multilobulated/septated appearance with a periphery that does not fully enhance. Note also how on straining (Valsalva) the mass results in proptosis. 

Findings are those of a low flow venous malformation.

Case Discussion

This patient had a vascular malformation - lateral orbitotomy - 7 years previously, with recurrence.

The distinguishing features between this entity and an orbital venous varix are:

  • slow enhancement - later than normal veins
  • incomplete enhancement
  • multilobulated/septated appearance

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