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PHOTO ESSAY
Year : 2016  |  Volume : 28  |  Issue : 2  |  Page : 148-149

Imaging features of orbital hemangioma


Department of Radiology, St. John's Medical College, Bengaluru, Karnataka, India

Date of Web Publication20-Mar-2017

Correspondence Address:
Reddy Ravikanth
Department of Radiology, St. John's Medical College, Bengaluru - 560 034, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_28_16

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How to cite this article:
Ravikanth R. Imaging features of orbital hemangioma. Kerala J Ophthalmol 2016;28:148-9

How to cite this URL:
Ravikanth R. Imaging features of orbital hemangioma. Kerala J Ophthalmol [serial online] 2016 [cited 2019 Sep 20];28:148-9. Available from: http://www.kjophthal.com/text.asp?2016/28/2/148/202472



A 25-year-old gentleman with complaints of insidious onset of proptosis of the right eye, orbital pain, and headache since 6 months presented to the ophthalmology outpatient department. On examination, vitals were stable andthere was no pallor. Local examination revealed swelling of the right orbit with no ptosis or diplopia. Contrast-enhanced computed tomography (CECT) examination of the orbits was requested. CECT orbits revealed a well-defined lobulated extraconal right orbital soft tissue density lesion isodense to the extraocular muscles with a contrast blush [Figure 1] and [Figure 2]. Calcifications were noted [Figure 3]. Mass effect was seen on the superior aspect of globe [Figure 4]. There was no destruction of the adjacent bony walls. A diagnosis of orbital hemangioma was made. Surgical removal was done following which the symptoms subsided.
Figure 1: CECT axial image of brain at the level of orbits showing contrast blush (arrow) of the lobulated lesion at the superior aspect of right orbit

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Figure 2: Axial plain CT image of the orbits in bone window showing a well-defined, lobulated lesion causing proptosis of the right globe (arrow)

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Figure 3: Axial plain CT image showing focus of calcification (arrow) in the extraconal right orbital lesion

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Figure 4: Coronal reformatted plain CT image demonstrating heterogeneously appearing lobulated lesion causing mass effect on the superior aspect of the right globe (arrow)

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Hemangiomas constitute the most commoncause of orbital masses. The most common location is the lower outer quadrant of the orbit.[1] The bony orbital wall could also be the site of primary hemangioma. Precise delineation of the lesion in relation to the orbital cone, assessment of compression of the optic nerve, extension of the tumor into the intracranial compartment, and demonstration of specific vascular components of the lesion can be done on imaging. CT may demonstrate bony orbital expansion and scalloping with rapidly growing lesions. Itmay also demonstrate fat deposition and heterogeneous appearing enhancement, if imaging is performed in the involution phase.[2] Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations.

Orbital hemangiomas are nonencapsulated, poorly circumscribed, irregularly marginated, often lobulated, and largely extraconal in location with heterogeneous appearance, and demonstrate intense enhancement on CECT. Orbital hemangiomas may cause proptosis, globe displacement, and occasionally amblyopia.[3]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bonavolontà G, Strianese D, Grassi P, Comune C, Tranfa F, Uccello G, et al. An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Ophthal Plast Reconstr Surg 2013;29:79-86.  Back to cited text no. 1
    
2.
Bilaniuk LT. Vascular lesions of the orbit in children. Neuroimag Clin North Am 2005;15:107-20.  Back to cited text no. 2
    
3.
Rosca TI, Pop MI, Curca M, Vladescu TG, Tihoan CS, Serban AT, et al. Vascular tumors of the orbit-cavernous and capillary hemangiomas. Ann Diag Pathol 2006;10:13-9.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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