A rare case of orbital and diffuse conjunctival venous malformation

Abstract

Cavernous hemangiomas (CH) are slow-flow venous malformations (VMs), not true vascular tumors. Although these are the most common benign orbital tumors in adults, conjunctival VMs are a rarity and account for less than 1% of all conjunctival tumors. We herein report a case of a 25-year-old male patient who presented with a large violaceous mass involving the inferior bulbar conjunctiva that had been present for 10 years. It was painless, progressive, and gradually increased in size over 10 years, and was associated with occasional bleeding. Any syndromic association was ruled out. Contrast-enhanced magnetic resonance imaging (CEMRI) revealed the presence of slow-flow vascular malformations involving the right superior and inferior eyelids with intraconal and extraconal involvement. An incision biopsy and histopathology (H/P) confirmed the diagnosis of formerly-called cavernous hemangioma (slow-flow VMs). The conjunctival mass was further managed by surgical debulking with ocular surface reconstruction, whereas the intraorbital part was kept under observation owing to its small size. The postoperative period was uneventful.