Orbital venous malformation

Case contributed by Assoc Prof Frank Gaillard
CT

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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