Thrombosed orbital varix – a correlation between imaging studies and histopathology

Abstract

A thrombosed varix in the orbit is comparatively rare. Clinical examination alone is often inadequate for diagnosis. Radio-logical examination, such as a computed tomography (CT) scan of the orbit, is extremely important. Histopathological examination (HPE) after excision biopsy can confirm the diagnosis. The present authors describe a case of proptosis in the left eye of a 45-year-old man. CT-scan and HPE supported the diagnosis of a thrombosed orbital varix. This paper discusses the use of radiological investigations to supplement a clinical suspicion and make the diagnosis. This entity needs to be included in the differential diagnosis of proptosis and requires a coordinated approach for establishment of the diagnosis.

Trombosis aguda de variz orbitaria: A propósito de un caso

“…Las varices orbitarias son masas intraorbitarias infrecuentes. Son consideradas malformaciones venosas congénitas [1][2][3]5 . Están constituidas por vasos venosos anómalos de bajo flujo y baja presión que presentan comunicación directa con el sistema venoso sistémico.…”

“…They are considered congenital venous malformations. [1][2][3]5 They are made up of anomalous venous vessels with low flow and low pressure that are directly communicated with the systemic venous system. 2,3,5 They may be made up of a single venous vessel or by a plexus.…”

“…11 Ocasionalmente, las varices pueden sufrir trombosis y hemorragia, pudiendo incluso a llegar a producir un síndrome compartimental orbitario con dolor intenso, pérdida de agudeza visual, náuseas y vómitos, aunque, afortunadamente esto sea poco frecuente. [1][2][3]8,9,11 El diagnóstico se basa en la clínica y radiología. Ésta última incluye la TC, RM, ECO -Doppler y arteriografía.…”

What is Important in The Diagnose of Orbital Varix?

“…Primary OVV can be idiopathic or congenital. Secondary OVV are acquired due to increased blood pressure because of intracranial arteriovenous malformations, caroticocavernous fistula or dural arteriovenous fistula (4,5).…”

Vascular Malformations of the Orbit

“…Distensible VMs have been encountered that may become acutely painful if they undergo thrombosis or hemorrhage or even on sudden dilatation associated with physical stress 37,39 (Fig. Distensible VMs have been encountered that may become acutely painful if they undergo thrombosis or hemorrhage or even on sudden dilatation associated with physical stress 37,39 (Fig.…”