International Journal For Multidisciplinary Research

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Spontaneous orbital hemmorage revealing a cavernous hemangioma

Author(s) EL ARARI Nihal, BENCHEKROUN Saad, HAMIDI Salma, EL HACHIMI Rim, L.O CHERKAOUI, BOUTIMZINE Noureddine, TACHFOUTI Samira, Lo Cherkaoui
Country Morocco
Abstract Introduction:

Orbital cavernous hemangiomas (OCH) are benign vascular tumors that commonly affect females, constituting around 4.3% of orbital tumors. These lesions often remain asymptomatic but may present with gradual proptosis or visual disturbances. Although rare, spontaneous orbital hemorrhage resulting in acute symptoms can serve as the first clinical manifestation of an OCH, necessitating urgent intervention in some cases. To date, only 11 cases of spontaneous orbital hemorrhage due to cavernous hemangioma have been reported in the literature.

Case Presentation:

We present a case of a 25-year-old male who presented with acute visual loss, painful proptosis, and orbital swelling, two days following a spontaneous hemorrhage. The patient had a history of Crohn’s disease, which had been untreated for two years. On examination, the right eye showed significant proptosis, impaired visual acuity, and a relative afferent pupillary defect. Orbital MRI revealed a well-defined lobulated mass with proptosis and an orbital hematoma, consistent with a cavernous hemangioma. Retinal OCT showed cystoid macular edema and chorioretinal folds. The patient was managed conservatively with NSAIDs and eye drops, leading to a progressive resolution of the hematoma over two months. Follow-up showed improvement in visual acuity and a reduction in proptosis.

Discussion:

OCHs are typically diagnosed through clinical presentation and imaging, with MRI being the gold standard. Although cavernous hemangiomas are usually asymptomatic, their rupture can lead to acute orbital hemorrhage, a rare but critical complication. This case represents a rare manifestation of spontaneous orbital hemorrhage due to an OCH, which resolved with conservative management. Surgical intervention is typically reserved for cases involving significant visual compromise or progression. This case emphasizes the importance of a conservative approach in managing spontaneous hemorrhages from OCH, highlighting the potential for recovery with non-surgical treatment.

Conclusion:

Orbital cavernous hemangiomas may present acutely with orbital hemorrhage, a rare complication that can often be managed conservatively. Our case illustrates a favorable outcome without the need for surgical intervention, underscoring the potential for spontaneous resolution and the importance of close monitoring in such cases. Further studies are needed to better understand the management of spontaneous hemorrhages from orbital cavernous hemangiomas.
Keywords cavernous, hemangioma, orbital hemorrhage, conservative treatment, orbital tumors.
Field Medical / Pharmacy
Published In Volume 7, Issue 2, March-April 2025
Published On 2025-03-03
DOI https://doi.org/10.36948/ijfmr.2025.v07i02.38038
Short DOI https://doi.org/g86xc3
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