Bilateral cavernous haemangiomas of the orbit

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Abstract
A 37 year old man developed distorted vision in the inferior field of his left eye and was found to have mild left proptosis. There was mild swelling of the left optic disc and a small inferonasal visual field defect. Orbital computed tomography (CT) revealed bilateral orbital masses and the patient was referred to the oncology service for another opinion and management. His visual acuity was 6/6 in each eye and colour vision was normal in both eyes. The only positive findings were 3 mm of left proptosis, mild swelling of the left optic disc, and a subtle inferonasal field defect. The orbital CT showed a round, soft tissue mass in the left orbit temporally that displaced the retrobulbar portion of the optic nerve nasally. A similar but smaller mass was present in the right orbit lateral to the medial rectus muscle (Fig 1). Both masses showed slight contrast enhancement. The clinical diagnosis was bilateral cavernous haemangioma. The left orbital mass was removed intact by a superolateral extraperiosteal approach. Gross and microscopic studies revealed a benign tumour composed of large endothelial lined vascular channels separated by fibrous stroma, consistent with cavernous haemangioma (Fig 2). The patient had an unremarkable postoperative course with good visual acuity.

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