| Print Date: | June 20, 2013, 1:12 am |
| Title | Cavernous Hemangioma |
| Text | Cavernous hemangioma(CH) is the most common benign orbital tumor of adults which can present either superficially or within the orbit(1). The term generally refers to a cavernous space lined by flat endothelial cells surrounded by a fibrous capsule or pseduo-capsule and is not related to the capillary hemangioma of childhood(2). The etiology is unknown although there are two popular theories for development. The first states that CH is likely the result of a incorporation of numerous vascular dilations and that the capsule develops as the spaces are incorporated into a larger lesion. The other theory is focuses on capillary proliferation in response to localized ischemia where the capillaries are later incorporated.
On CT and MR imaging they appear as ovoid structures, often homogeneous and isointense to muscle on TI-weighted images and are hyperintense on T2-weighted images. [In this way, they are unlike the CH of the brain, which retain blood products causing heterogeneous mixed bright and dark areas on both T1w and T2w images. They are largely isolated from systemic circulation with very slow flow and may not opacify or blush with contrast until after a prolonged delay. On MR, they will sometimes demonstrate internal septations or lobulations as they grow larger. The condition is only found in adults and one large study reports a 7:3 predilection for women with an average age of onset of symptoms at 42. The lesion is rarely bilateral and is normally discovered on CT or MRI performed for other reasons.(2) Normal symptoms may range from weeks to decades of painless progressive proptosis(72%) Less commonly, there can be optic nerve impingement or hyperopia secondary to compression, which may demonstrate choroidal striae on SLE (slit lamp examination). There is no known progression to malignancy and management is surgical resection(3). |
| References: | 1. Ann G Neff, Keith D Carter, Yanoff Ophthalmology First Edition, Chapter 11 - Orbit and Oculoplastics, Section 1 Eyelids - Benign Eyelid Lesions, 1999 Mosby international Ltd.
2. Larissa T. Bilaniuk, Imaging in Ophthalmology H: Orbital Vascular Lesions: Role of Imaging, Radiologic Clinics of North America, Volume 37 • Number 1 • January 1999 3. B. L. Linda Vu MD, FRCSC, Gerald J. Harris MD, Oculoplastic Surgery Update Orbital Vascular Lesions, Ophthalmology Clinics of North America, Volume 13 Number 4 - December 2000 |
| Contributor | MS-4 USU Teaching File (Uniformed Services University) |
| Author | Herb Kwon |
| Peer Reviewer | James G. Smirniotopoulos, M.D. (Uniformed Services University) |
| Record Number | : 2696 |
| Created | 2001-08-21 09:16:57-04 |
| Modified | 2001-09-27 12:54:00-04 |
| Category: | Vascular |
| Location: | Eye and Orbit (exclude Ophthalmology) |
| Sublocation: | Intraconal |
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