Rare coexistence of spindle cell hemangioma and cavernous hemangioma in the orbit: A case report and literature review

IntroductionThe coexistence of heterogeneous tumors, spindle cell hemangioma (SCH) and cavernous hemangioma, is a rare clinical presentation. SCH is an uncommon vascular disease that most often presents as cutaneous or subcutaneous nodules in the distal extremities and only rarely in deep soft tissues.Case presentationA 57-year-old woman developed secondary orbital involvement with two tumors 40 years after removal of a cavernous hemangioma in the same orbit. CT and MRI images showed two tumors in the left orbit. Both were removed entirely via a transconjunctival anterior orbital approach combined with a nasal endoscopic transethmoidal approach. Pathology showed SCH and cavernous hemangioma.ConclusionCoexistence of SCH and cavernous hemangioma in the same area suggests a continuum and a shared origin. Although SCH is rare and its preoperative diagnosis is challenging, it should be included in the differential diagnosis of cavernous hemangioma.