Orbital cavernous haemangioma; profile and outcome of 76 patients managed surgically

Acta Otolaryngol. 2019 Aug;139(8):720-725. doi: 10.1080/00016489.2019.1618913. Epub 2019 Jun 1.


Background: Orbital cavernous haemangioma (OCH) is one of the most common primary orbital tumours in adults. They can encroach on intraorbital or adjacent structures and be considered 'anatomically' malignant. Aims: To report a series of patients that were all managed surgically, with possible specificities and propose predictors of treatment outcome. Methods: We realised a hospital-based retrospective case review including data from 76 patient files. Results: The mean age was 37.8 years. Unilateral proptosis was observed in all patients. Visual loss was found in 32 patients (42.1%). Findings on eye examination included lagophthalmos (76.3%), blepharoptosis (21.1%), complications of corneal exposure (19.6%), strabismus (13.2%) and fundoscopic abnormalities (60.5%). Abnormal fundoscopy was significantly associated with decreased visual acuity (VA) (p < .001). Small tumours were predominant (65.8%) and size was associated with VA (correlation coefficient r = -0.5, p < .001). Surgery was mainly by lateral orbitotomy (94.7%), with early post-operative complications in 18 patients (23.7%). Multivariable analysis showed that tumour size, preoperative VA and abnormal fundoscopy were significantly associated with postoperative VA. Conclusion: Clinical and radiological profiles are consistent. Tumour size, preoperative VA, and abnormal fundoscopy seem to be important factors that could influence outcome expectations. Surgical management is still predominantly by open approaches. Severe complications remain rare.

Keywords: Orbital cavernous haemangioma; orbital cavernous vascular malformation; orbitotomy; treatment outcome.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Hemangioma, Cavernous / diagnostic imaging
  • Hemangioma, Cavernous / pathology
  • Hemangioma, Cavernous / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures / adverse effects
  • Ophthalmoscopes
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / pathology
  • Orbital Neoplasms / surgery*
  • Postoperative Complications
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Visual Acuity