Conservative Management of a Slow-Flow Orbital Cavernous Hemangioma: A Case Report

Orbital cavernous hemangiomas are the most common benign orbital tumors in adults, typically presenting as slowly progressive, painless proptosis. These lesions can lead to cosmetic concerns, optic nerve compression, and, in severe cases, visual impairment. Timely diagnosis and appropriate management are crucial. This case report presents the diagnostic approach, management, and follow-up of a patient with a slow-flow orbital cavernous hemangioma, adhering to conservative management principles. A 37-year-old woman presented with a six-month history of progressive left eye proptosis without visual disturbances or pain. Physical examination revealed non-pulsatile proptosis with normal visual acuity and no optic nerve involvement. Laboratory investigations, including thyroid function tests, were unremarkable. Orbital ultrasonography revealed a well-defined hypoechoic mass and subsequent magnetic resonance imaging confirmed a 2.5 cm, lobulated, hyperintense lesion in the left orbit, consistent with an orbital cavernous hemangioma. The lesion was extraconal, displacing but not compressing the optic nerve. A diagnosis of a slow-flow orbital cavernous hemangioma was made. Orbital cavernous hemangiomas can be effectively managed conservatively in cases with minimal symptoms and no visual impairment. Regular follow-up is essential to monitor for progression, and surgical intervention should be reserved for cases with significant proptosis or optic nerve compression.