Spontaneous orbital haemorrhage secondary to cavernous haemangioma – a case summary and review of literature

Purpose: Orbital haemangiomas are common orbital tumors known for their slow growth. Acute presentation with haemorrhage into the tumor is a rare occurrence with only nine cases reported in literature. Methods: The authors present a case of an elderly female with sudden onset of proptosis and swelling of the eye. There was a transient relief of symptoms with steroids with residual proptosis and ptosis at two weeks. Magnetic resonance imaging revealed an intraconal soft tissue mass in the inferolateral quadrant of the left orbit with a differential diagnosis of haemangioma with bleed or metastasis. Results: Patient underwent a lateral orbitotomy and tumour excision and histopathological examination revealed a cavernous haemangioma with a thrombus. The patient had complete symptomatic recovery following surgery. Conclusion: Orbital haemangiomas presenting with haemorrhage is rare and should be differentiated from orbital venous anomalies prior to surgery.