Clinical Course Of An Incompletely Removed Cavernous Hemangioma Of The Orbit
Henderson, J. W., Farrow, G. M., & Garrity, J. A. (1990). Clinical course of an incompletely removed cavernous hemangioma of the orbit. Ophthalmology, 97(5), 625–628. https://doi.org/10.1016/s0161-6420(90)32533-2
View Original Source →Abstract
Cavernous hemangioma is a frequent tumor of the orbit in adults. Its complete removal results in dramatic relief of proptosis. The clinical course of an incompletely removed cavernous hemangioma is seldom recorded in the ophthalmic literature. The authors report the behavior of such a tumor that was observed during an 18-year period. Serial computed tomography (CT) documented a long period of slow growth, followed by a shorter interval of arrest, with eventual involution of tumor and relief of proptosis. No treatment was administered during observation.
Case Details
Disease Location
Left orbital cavernous hemangioma
Personal Characteristics
43-year-old male
Clinical Characteristics
43-year-old male presented with 5mm left eye protosis -> given empiric abiopsy for possible infection but protosis worsened over the next 12 months. Imaging nondiagnostic (CT n/a in 1969). Clinical dx of left orbital tumor. Lateral orbitotomy performed 1 years later during which the tumor ruptured -> loose fragments removed but further dissection not attempted. Post -op proptosis improved. Annual follow ups showed progressive worsening of the proptosis with max 9 years from surgery, exam at this time also showed pale optic disc and aprd. CT scan done in 1979 showed large mass and surgical risks seemed to outweigh benefit due to risk of complete blindness. CT in 1981 showed worsening with bone erosion of the orbit. New visual symptoms like field defects and scotomas. After 1983, serial CT scans (last in 1988) showed shrinkage of tumor and exams improvement of proptosis.
Remission Characteristics
After 1983 (diagnosed in 1969), serial CT scans (last in 1988) showed shrinkage of tumor and exams improvement of proptosis.
Treatment & Mechanisms
Proposed Remission Mechanisms
Could be "natural course" of cavernous hemangioma
Clinical Treatment
Partial resection due to inadverightant intra-op rupture of the tumor