Cavernous hemangioma of the orbit: 42 patients

Background/Purpose: To analyze clinical features and treatment results of 42 patients with cavernous hemangioma of orbit. Design: A retrospective chart review of cases. Methods: Between 1976 and 2011, 42 patients with pathologically proven cavernous hemangioma of the orbit were referred to, and treated by, the authors. The clinical features and treatment outcomes were analyzed. Results: The retrospective study included 42 cases of symptomatic tumors that were completely removed by means of anterior orbitotomy (8/42, 19%), lateral orbitotomy (30/42, 71%), and transcranial approach (4/42, 10%). There were more female cases than male cases (29:13). Ages ranged from 17 years to 71 years (mean 46.2 years ± 6.8 years). Most of the tumors (32/42, 76%) were located in the muscle cone. The left orbit was affected in 18 cases, and the right orbit in 24 cases, no case was bilaterally involved. Painless, gradually progressive proptosis (exophthalmos) and visual disturbance were the main clinical signs. Of the cases, 90% (38/42) could be accurately diagnosed preoperatively based on ultrasound scan and computed tomography/magnetic resonance imaging examination. Improvement (or no change) of visual function (35 cases, 83%) was achieved in the 42 cases who received surgical treatment. No recurrence was noted during a 6 month to 136 month follow-up period. Conclusion: Nearly 90% of 42 patients with cavernous hemangioma of orbit could be correctly diagnosed preoperatively. The location of tumor determined the choice of surgical approach. Orbitotomies with careful dissection and cryoprobe extraction of the tumor have been successfully used in 32 cases. Among the 42 patients who received surgical treatment, good outcome of visual function (83%) was achieved. All patients were regularly followed up at least 6 months (range, 6-136 months; mean 16.4 months) and no recurrence was noted.