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We report an unusual presentation of an orbital cavernous hemangioma in a 26-year-old female, who noted sudden redness and swelling of the left eye (LE) on waking up. At presentation, upper eyelid edema with periorbital ecchymosis and subconjunctival hemorrhage were noted in the LE. Although there was transient symptomatic relief with topical medic...
Citations
... Biasanya keluhan proptosis yang progresif lambat tanpa adanya rasanya nyeri juga dikeluhkan pada hemangioma cavernosa orbital. 7,14 Hemengioma kavernosa di kelopak mata bawah jarang terjadi, biasanya pada kelopak mata atas. 1,8 Pada konjungtiva tarsal palpebra inferior terdapat warna kebiruan adalah tanda patognomonik dari anomali aliran keluar vena. ...
Approximately 6-9% of all orbital tumors are orbital cavernous hemangiomas, which are the most prevalent kind of orbital lesion. A case of a 34-years-old male presented with a painless and palpable mass in the lower eyelid, left eye (LE) since three years ago. There was a bluish discoloration of the tarsal conjunctiva of the lower eyelid. The patient underwent resection of the tumor mass, the histopathological results of cavernous hemangioma. Cavernous hemangioma may present in the lower eyelid, which is an uncommon location. Most cavernous reported several cases of cavernous hemangioma in the upper eyelid. But only one case was reported in the lower eyelid, so it is important to keep in mind the differential diagnosis of other eyelid tumors.
... CVMs can occasionally cause mild visual impairment, retinal streaks, papilledema, blurred vision, double vision, eyelid swelling, pain, mechanical ptosis, corneal exposure, and gaze-evoked amaurosis (18,21,23,(34)(35)(36) . Acute symptoms such as hemorrhage and periorbital ecchymosis rarely occur (37)(38)(39) . Symptoms are usually reversible unless the injury causes a permanent axial length change or optic nerve dysfunction (35) . ...
Vascular anomalies comprise a wide spectrum of clinical manifestations related to disturbances in the blood or lymph vessels. They correspond to mainly tumors (especially hemangiomas), characterized by high mitotic activity and proliferation of the vascular endothelium, and malformations, endowed with normal mitotic activity and no hypercellularity or changes in the rate of cell turnover. However, the classifications of these lesions go beyond this dichotomy and consist various systems adapted for and by different clinical subgroups. Thus, the classifications have not reached a consensus and have historically caused confusion regarding the nomenclatures and definitions. Cavernous venous malformations of the orbit, previously called cavernous hemangiomas, are the most common benign vascular orbital lesions in adults. Herein, we have compiled and discussed the various evidences, including clinical, radiological, morphological, and molecular evidence that indicate the non-neoplastic nature of these lesions.
Keywords
Orbital neoplasms; Vascular malformations; Vascular system injuries; Cavernous hemangioma; Cavernous venous malformations; Biomakers; tumor; Endothelium; vascular; Cell proliferation
... 1,2 They are usually well circumscribed and have no potential for malignancy. 1 It is estimated that 80% of orbital hemangiomas are housed in the intraconal compartment (between the Tenon's capsule and the extraocular muscles) usually in the lateral direction. 3 In addition, the prevalence encompasses women and generally occurs in middle age. 3 It is worth pointing out that they are usually asymptomatic, but patients with this tumor may present visual symptoms, such as ptosis and vision deficits by compression of the second cranial nerve pair-the optic nerve-in addition to psychological and aesthetic impairment. 1,4,5 Preoperative evaluation is essential and makes the use of imaging tests essential to carry out an adequate planning, with computed tomography (CT) and magnetic resonance imaging being the first choices. ...
... 3 In addition, the prevalence encompasses women and generally occurs in middle age. 3 It is worth pointing out that they are usually asymptomatic, but patients with this tumor may present visual symptoms, such as ptosis and vision deficits by compression of the second cranial nerve pair-the optic nerve-in addition to psychological and aesthetic impairment. 1,4,5 Preoperative evaluation is essential and makes the use of imaging tests essential to carry out an adequate planning, with computed tomography (CT) and magnetic resonance imaging being the first choices. ...
... Cavernous orbital hemangiomas (HCOs) are benign circumscribed vascular malformations and with a slow growth development (1)(2)(3)(4)(5) and may in some cases present acutely. 3 They are usually found in middle-aged adults and represent about 4 to 6% of all the intraorbital masses of the orbit/retrobulbar masses of the orbit. ...
Cavernous hemangiomas are benign malformations of vascular origin, usually well circumscribed and slow to grow. These lesions can be asymptomatic, being discovered unintentionally in imaging exams or symptomatic, indicated mainly by the presence of proptosis, diplopia, and visual disturbances by optic nerve compression. The complementary exams involve computed tomography associated with contrast, color Doppler, magnetic resonance, and angiography. Treatment can be conservative or surgical depending on the case, and the open therapy usually involves lateral, supraorbital, transconjunctival, transantral, pterional, transnasal, and extradural endoscopic orbitotomy. The present study aims to report a recurrent case of hemangioma in the orbital cavity signaled by ocular proptosis, hyperemia, and ocular pain.The lesion was achieved through the Weber-Ferguson access with zygomatic osteotomy and preservation of the infraorbital nerve. The excision of the lesion was performed, and the previously displaced fragments were fixed with 1.5 mm mini plates. The patient has a chance of progressing with visual impairment due to considerable manipulation of the optic nerve and is being followed up.The reported case showed a successful diagnosis and therapeutic conduct, remaining now in the evolution and follow-up scenario.
... An acute intralesional hemorrhage of an orbital CVM is rare, [3] with only a few cases having been reported. [4][5][6][7] Interestingly, most of the acute lesions were in the left eye. [4][5][6][7] The mechanism of intralesional hemorrhaging of an orbital CVM remains unclear. ...
... [4][5][6][7] Interestingly, most of the acute lesions were in the left eye. [4][5][6][7] The mechanism of intralesional hemorrhaging of an orbital CVM remains unclear. It may be caused by inflammation of the small capillaries within the CVM. ...
Orbital cavernous venous malformations (CVMs) are usually slow progressing. Multiple CVMs, bilateral orbital CVMs, and acute presentations are rare. We present a rare, bilateral, orbital CVM with acute painful visual loss in the left eye. The initial clinical presentation mimicked an idiopathic orbital inflammation. Orbital magnetic resonance imaging revealed its rare location at the left orbital apex. Finally, pathology confirmed the presence of an intralesional hemorrhage of a CVM.
... По данным зарубежных авторов, описанная патология может протекать бессимптомно в связи с малыми размерами венозных образований [8]. В литературе описаны случаи проявления кавернозной гемангиомы орбиты, капиллярной гемангиомы изолированными спонтанными гипосфагмами на фоне полного здоровья [9,10]. Частые субконъюнктивальные кровоизлияния характерны и для лимфангиомы [11]. ...
This publication describes a clinical case of spontaneous subconjunctival hemorrhage in a 15-year-old child on the background of idiopathic local dilatation of epibulbar vessels. Vascular pathology of the orbit and periorbital region is often accompanied by subconjunctival hemorrhages. The aim of the work was to describe a rare clinical case of spontaneous subconjunctival hemorrhage in a child with local idiopathic vasodilation. A complete clinical instrumental study revealed no pathology except the local dilatation of epibulbar vessels. In 6 months after the subconjunctival hemorrhage resorption, the ampoule-shaped expansion of the epibulbar vessels with a wall different from others in color and shape is preserved, which was confirmed by the data of optical coherence tomography (OCT) of the anterior eye segment. When examining patients with spontaneous subconjunctival hemorrhage, especially in childhood, along with pathology of the cardiovascular and circulatory systems, it is necessary to exclude malformations of the vessels of the orbit, periorbital region and anomalies of the epibulbar vessels.
... Обикновено са бавно растящи образувания и най-често водят до неболезнена проптоза с бавна динамика. Макар и рядко, могат да се проявят с внезапна симптоматика, като болка, диплопия, подуване в зоната на клепачите (11). В описания случай нашият пациент потърси помощ по повод внезапно появила се неболезнена подутина на долен десен клепач. ...
Cavernous hemangioma, currently known as “cavernous venous malformation,” is a common, benign, non-infiltrative, slowly progressive vascular malformation of the orbit presenting in adults. We report the case of a 9-year-old girl who presented with a painless palpable mass over the right upper eyelid of 7 years’ duration. A computed tomography scan of the orbits revealed a heterogeneously enhancing, well-circumscribed mass in the right upper eyelid with no orbital extension. A transcutaneous excisional biopsy with histopathology disclosed cavernous venous malformation. The majority of cavernous venous malformations are intraconal and present in the fourth to fifth decade of life.
The spectrum of disease manifestations for a given disease is highly specific and reproducible across phylogenetic lines. Examined on a population basis, the erosions of rheumatoid arthritis are polyarticular in distribution, while those of spondyloarthropathy are more oligoarticular. The erosions in rheumatoid arthritis are periarticular in distribution, affecting the subchondral bone surface only in their expansion, contrasted with spondyloarthropathy which is predominantly subchondral in distribution. Joint fusion/ankylosis is limited to spondyloarthropathy, infection, and post-trauma. Axial joint disease (the junction of the first two cervical vertebrae) does not occur in rheumatoid arthritis. Rheumatoid arthritis first appears in the Green and western portion of the Tennessee rivers around 6500 ybp, spreading to Ohio approximately 1000 ybp and became more generalized ~300 years ago. Diagnosis of rheumatoid arthritis exclusive of humans cannot be verified. Documentation that individuals with axial joint involvement, primarily subchondral surface erosion and/or ankylosis, have a disease other than rheumatoid arthritis is provided by biochemical evidence, characterization of erosive arthritis in non-human animals, and the archaeological record. Spondyloarthropathy is an ancient disease, identified in dinosaurs and as early as the Permian in synapsids. Spondyloarthropathy is characterized by enthesitis, as well as specific skeletal alterations. Ankylosing spondylitis is perhaps one of the least prevalent of the five forms of spondyloarthropathy. Distinguishing diffuse idiopathic skeletal hyperostosis from spondyloarthropathy is sometimes challenging as the former can complicate the latter. Juvenile inflammatory arthritis/juvenile rheumatoid arthritis often shares characteristics with spondyloarthropathy, resulting in its diagnosis only rarely considered. Gout produces characteristic erosions with sclerotic margins and overhanging edges, affecting almost any joint. Gout is trans-phylogenetic phenomena, recognizable as far back as dinosaurs. Calcium pyrophosphate deposition disease produces crumbling erosions and calcific sheets reflecting over articular surfaces and calcific masses on those surfaces. Calcium pyrophosphate deposition disease may be primary or may complicate other forms of arthritis, including osteoarthritis. Calcium pyrophosphate deposition disease is trans-phylogenetic and ancient, having been recognized in hadrosaurs.
Cavernous hemangioma of orbit is a benign, noninfiltrative, slowly progressive vascular neoplasm. It is usually asymptomatic but patients may present with proptosis and diminished vision due to compression of second cranial nerve, optic nerve. This can be usually diagnosed with the help of clinical examination and computed tomography (CT) or magnetic resonance imaging (MRI). Small sized tumours are worth wait and watch while large ones need surgical excision. In our case report, A 65-year-old male patient presented to the head and neck surgery with proptosis of left eye since 5 years along with decreased vision since 4 years. MDCT scan (orbits plain) suggestive of large solid retroocular, intraconal mass in left orbit leading to proptosis of left eyeball. The patient underwent excision of tumour through a transnasal endoscopic approach. Histopathological examination of the tumour identified as cavernous hemangioma. It is safe and effective way to access and excise the orbital tumours through the transnasal endoscopic approach. It is essential to have experienced surgeon in endoscopic procedures. The patient had satisfactory results at three months follow up and showed no symptoms or relapse on CT scans of orbital region.
Periocular haemorrhage without a preceding history of trauma, and in the absence of vascular malformations is rare. While acute proptosis is well described in the setting of orbital pathology, accompanying periocular haemorrhage has been rarely reported. We describe three cases with these concomitant presenting signs in orbital malignancies – metastatic small cell bladder carcinoma, haemangiopericytoma (solitary fibrous tumour) and myeloma. Clinical photographs and radiology are presented with review of the current literature. All cases had an associated rapid onset of severe proptosis and co-existing periocular bruising on the same side. The presence of ecchymosis of the eyelids in addition to proptosis without a history of trauma warrants thorough investigation to rule out underlying potential sight and life threatening illness.
