Cavernous hemangioma of the orbit: Analysis of 214 cases

Yan, Jianhua; Wu, Zexuan

doi:10.1076/orbi.23.1.33.28992

Cited by 108 publications

(93 citation statements)

References 5 publications

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“…1,3,5,10) In contrast, conservatively managed patients remained stable during a followup period of 3-10 years. 7) Present case showed progressive ocular symptoms caused by the orbital lesion and underwent a surgical exploration.…”

Section: Discussionmentioning

confidence: 99%

“…8) Surgical resection is indicated in symptomatic patients presenting impaired visual function or ocular movements, progressing exophthalmos, and symptoms of increased intraorbital pressure. 1,5,7,10) Orbital CH has specific neuroimaging findings of circumscribed enhanced mass, which indicates that total resection is feasible without postoperative worsening of visual impairment. 3,7,8) However, some orbital CHs have had tight adhesion with the surrounding tissue without the circumferential capsule, which makes surgical resection hazardous.…”

Section: Introductionmentioning

confidence: 99%

“…6,8,10) Orbital CH has a typical macroscopic appearance of a dark plum-colored mass with variable trabeculated surface depending on the thickness of the fibrous capsule and septae. 8) Surgical resection is indicated in symptomatic patients presenting impaired visual function or ocular movements, progressing exophthalmos, and symptoms of increased intraorbital pressure.…”

Section: Introductionmentioning

confidence: 99%

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Orbital Cavernous Hemangioma Presenting With Atypical Appearance -Case Report-

Akiyama

Tsutsumi

Suga

et al. 2009

Neurol. Med. Chir.(Tokyo)

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A 25-year-old male presented with unilateral retroorbital dysesthesia persisting for 2 weeks followed by progressive palpebral ptosis without preceding trauma, paranasal sinus surgery, or infectious signs. Neuroophthalmological inspection revealed mildly increased intraocular pressure and exophthalmos on the affected side, without conjunctival chemosis, restriction of the extraocular movements, double vision, or visual impairment. These symptoms did not vary with posture, straining, and Valsalva maneuver. Neuroimaging showed an irregularly-shaped orbital mass without enhancement mainly situated in the medial compartment of the orbit and encasing the optic nerve. Bruit was not audible and abnormal vasculatures were not identified in and around the affected orbit. Transcranial surgical exploration through the surgical window formed by the superior and medial rectus muscles revealed a purplish elastic-soft mass, heterogeneous in consistency and tightly adhering to the surrounding tissue, so cryoprobe-assisted radical tumor resection could not be completed without jeopardizing the optic nerve. The mass was subtotally resected piecemeal without postoperative visual impairment. The histological diagnosis was cavernous hemangioma. Orbital cavernous hemangiomas may present with an atypical appearance which confuses pretreatment diagnosis and makes surgical extirpation more hazardous. Conservative surgery should be indicated for poorly demarcated orbital cavernous hemangiomas considering the usual benign clinical course and postoperative sequelae.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Orbital Cavernous Hemangioma Presenting With Atypical Appearance -Case Report-

Akiyama

Tsutsumi

Suga

et al. 2009

Neurol. Med. Chir.(Tokyo)

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Section: Discussionmentioning

confidence: 99%

“…Surgical treatment of CH has been associated with low risk and effective symptom alleviation. 2,6,13,22 However, lesions that are close to the arteries and nerves of the orbit, as in this case, are difficult to resect safely 14 and can make complete removal complicated.11 Surgical alternatives such as stereotactic radiosurgery have been used successfully to treat CHs. 13,21 In our pregnant patient, both surgical and radiosurgical treatment were considered lastline treatment.…”

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Conservative management of cavernous sinus cavernous hemangioma in pregnancy

Haber

Kesavabhotla

Ottenhausen

et al. 2014

JNS

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Key WorDs • cavernous sinus • cavernous hemangioma • pregnancy • oncologyAbbreviations used in this paper: CH = cavernous hemangioma; CS = cavernous sinus; VEGF = vascular endothelial growth factor. This article contains some figures that are displayed in color on line but in black-and-white in the print edition. J. S. Haber et al. 1310J Neurosurg / Volume 120 / June 2014 tion, she was referred to an outside neurologist who found ophthalmoplegia of the left eye and sensory deficit in the left V1 distribution.Clinical Course. The patient was then referred to the emergency department of the NewYork-Presbyterian Hospital where her examination was notable for 2 mm of ptosis in the left eye, impaired adduction, elevation, and depression of the left eye consistent with a partial left oculomotor nerve palsy and an inability to abduct the left eye, consistent with a complete left abducens palsy. Magnetic resonance imaging showed an expansile mass in the left CS (Fig. 1A) presumed to be a schwanomma.Several weeks later, the patient's left periorbital pain and numbness as well as the vertical motility of the left eye improved. However, repeat MRI showed a slight increase in lesion size and multiple serpentine T2 hyperintense structures, which together were suggestive of a CSCH (Fig. 1B). A cesarean section was recommended to reduce the risk of enlargement and hemorrhage during delivery. The neurosurgery team recommended no acute surgical treatment given the extent of the lesion within the CS, close follow-up, and postpartum imaging to assess for possible spontaneous involution.At 30 weeks of gestation the patient presented with progressive left orbital pressure, lid edema, worsened ptosis to 5 mm of the left eye and a new 2-mm anisocoria with mydriasis of the left eye. Repeat MRI revealed a significant enlargement of the lesion with extension to the orbital apex (Fig. 1C). There was severe compression of the left internal carotid artery and increased impingement of the left optic nerve. The patient was offered the option of immediate delivery, but she declined. A cesarean section was scheduled for 37 weeks.At 35 weeks of gestation, the patient was referred to a neuro-ophthalmologist for declining left visual acuity. Neuro-ophthalmic examination confirmed a complete left abducens palsy and partial left oculomotor palsy, including a mild adduction defect, mild ptosis and mydriasis, worse in light. However, there was no relative afferent pupillary defect. Visual acuity in the left eye improved with a +2 lens, consistent with blurry vision from a lens accommodation paresis associated with the oculomotor palsy rather than from optic nerve compression (Fig. 2).Postpartum Course. The patient underwent the scheduled cesarean section without complication. Two weeks postpartum, she developed complete ptosis and decreased supra-and infra-adduction of the left eye, consistent with worsened oculomotor nerve function. Furthermore, in addition to left mydriasis in the light, a relative miosis in dim light had developed, consistent with ...

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