Abstract
A 63-year-old woman presented with a 15-year history of gradually increasing proptosis of right eye. Ocular examination revealed proptosis of 9 mm with decreased visual acuity in her right eye. CT scan showed a well-circumscribed and enhancing orbital mass filling almost the entire right orbit. The tumor occupied the superolateral, superomedial, and inferomedial intraconal space, enveloping the optic nerve. Complete excision of two large intraconal tumors was performed successfully via a vertical lid split orbitotomy. Histopathologic examination confirmed the diagnosis of cavernous hemangioma. There were no intraoperative or postoperative complications. The patient achieved a satisfactory cosmetic outcome 1 year after surgery.
Highlights
A lateral orbitotomy can be used as a primary approach for surgical removal of cavernous hemangioma located intraconally [1]
Computed tomography (CT) scan showed that the tumor occupied the superolateral, superomedial, and inferomedial intraconal spaces, enveloping the optic nerve and displaced the globe anteriorly and inferolaterally
Several surgical approaches for intraconal orbital tumor have been described in relation to the location and size of the lesion
Summary
A lateral orbitotomy can be used as a primary approach for surgical removal of cavernous hemangioma located intraconally [1]. It is challenging to decide the appropriate surgical approach to remove large tumor when it is located in the medial intraconal space [2]. Approaches which have been described to excise large intraconal tumors include combined medial and lateral orbitotomy or circumferential pan-orbitotomy [3]. The current case illustrates successful excision of huge intraconal cavernous hemangiomas enveloping the optic nerve via a vertical lid split orbitotomy
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