English

Abstract

We are presenting a rare case of 8months old female baby from Gulbarga who was brought to our hospital with chief complaints of swelling in right eye since 6 days. There was no history of trauma or fever. Patient was subjected to ultrasound and a hypoechoic lesion was noted in the retrobulbar area. Later patient underwent CECT and MRI for further evaluation and it was finally diagnosed as lymphangioma, also called lymphatic-venous malformation. The patient underwent surgery and the final histopathological diagnosis came to be lymphangioma. INTRODUCTION: Lymphangiomas are benign hamartomatous tumors which are usually diagnosed in early childhood. About 20% of these tumors involve the orbit and ocular adnexa 1 . These usually present at an early age, from infancy to the first decade of life. Venous-lymphatic malformation in the orbit is an anomaly of venous and lymphatic development that is characterized by non-enhancing, cystic lymphatic and enhancing solid venous components. Intralesional hemorrhage is common and frequently produces distinctive fluid-fluid levels within the cystic portion. CASE SUMMARY:An 8 month old female baby from Gulbarga was brought to our hospital with swelling of right eye. Patient was referred to radiology department for evaluation. Ultrasound: Hypoechoic solid mass lesion was noted in the retrobulbar area in right eye. Optic nerve appeared normal. No evidence of calcification was noted within the lesion or periphery of the lesion. Bulbar area of right eye appeared normal. Left eye appeared normal. On color Doppler: No vascularity was noted within the centre or periphery of the lesion. NECT: Evidence of hyperdense lesion with CT value of +50 to + 60 HU was noted in retrobulbar area in right eye. Lesion involved intraconal compartment. The lesion was predominantly located in the medial aspect of right eye. Optic nerve appeared normal but was pushed superiorly and laterally by the lesion. Proptosis of right eye was noted. Scalloping of right orbit was noted. No evidence of calcification was noted within the lesion or periphery of the lesion. Bulbar region of right eye appeared normal. Left eye appeared normal. CECT: Lesion showed moderate enhancement. MRI: Evidence of solid mass in right orbit was noted. It appeared to be heterogenous with large component which was hypointense on T1WI and hyperintense on T2WI. Lesion was intraconal in location. It measured around 32 x 22 mm in longitudinal and transverse dimensions and was located predominantly in the postero-medial aspect of the globe, with components also located anterior- inferior to the globe. Component located antero-inferior to the globe showed evidence of fluid levels. The globe itself appeared normal. Left eye appeared normal. Visualized intracranial structures were normal.