A 50 year old lady is presenting with a retrobulbar orbital tumor within the muscle cone. It has a well defined capsule and presents with slowly progressive proptosis. The diagnosis is:

Correct Answer: Cavernous hemangioma
Description: Cavernous hemangiomas are benign, grow slowly, and usually become symptomatic in middle life. Mostly occur in women. They most often lie within the muscle cone, producing axial proptosis, hyperopia, and, in many cases, choroidal folds. Unlike capillary hemangiomas, they do not tend to regress spontaneously. Surgical excision is usually successful and is indicated if the patient is symptomatic. Impoant points: Cavernous hemangioma is the most common benign orbital tumor in adults Usual age of onset is 4th - 6th decade of life If the tumor is intraconal - it presents with slowly progressive axial proptosis Visual acuity is normal unless it compress the optic nerve Encapsulated mass, typically unilateral and solitary Ref: Orbital Tumors: Diagnosis And Treatment, Edited by Zeynel A. Karcioglu, Page 143, Springer, 2005.
Category: Ophthalmology
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