From the case:
Orbital venous malformation
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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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