PerspectiveCavernous Hemangioma of the Orbital Apex: Pathogenetic Considerations in Surgical Management
Section snippets
Management Recommendations
Considering the risk of unchecked tumor growth into apical structures—and the risk of tumor removal from them—each case requires thoughtful analysis.
If a lesion with imaging features typical for hemangioma is serendipitously found in a patient with normal ophthalmic findings, then continued observation is indicated. At the time of discovery, it is unknown whether the lesion is actively growing or has been stable for years, and without vision impairment, the risk of surgery outweighs any
Case 1
A 51-year-old woman had been aware of blurred vision in the left eye for 2 years, orbital asymmetry for 18 months, and left-sided headache for 2 weeks. Best-corrected vision was 20/25 OD and 20/80 OS, with a 2+ left relative afferent pupillary defect (RAPD). The left globe was laterally displaced, relatively proptotic by 4 mm, and fully mobile. Orbital imaging showed a large tumor wedged between the optic nerve and the medial and inferior rectus muscles, with pressure expansion of the apical
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