Intraorbital cavernous hemangioma

Cavernous hemangioma is named for the cavernous sinus cavity in the tumor. It is the most common tumor in the orbit that occurs in adults, accounting for 10% to 23% of intraorbital tumors. Women are more common than men. The disease is a congenital hamartoma. The tumor consists of sinusoids and fibrous spaces of varying sizes, with a complete envelope. Due to the slow growth of tumors, it is often found after adolescence due to exophthalmos. It was thought that cavernous hemangioma was caused by increased intraluminal cavity pressure and luminal dilatation of capillary hemangioma, but neither the clinical nor pathological evidence could prove a causal relationship between the two. Because smooth muscle cells are found in the blood vessel wall, according to the development process of blood vessels, they belong to tumors with more mature angiogenesis after capillaries. Cavernous hemangioma is a solid oval tumor with clear borders and dark red color. It has a thin, intact fibrous envelope and a sponge-like cut surface. The tumor is connected to the systemic circulation by small arteries and veins, and the blood flow is slow. Hemorrhage, embolism, cystic changes, hemosiderin and calcification can be seen, and the volume is not affected by the receptor position. Under the microscope, there was a large amount of blood sinus and fibrous connective tissue in the tumor, and the fibrous tissue constituting the capsule continued to the fibrous tissue between the sinusoids. The inner layer of the sinus cavity is endothelial cells, and unevenly distributed smooth muscle fibers can be seen in the fibrous interval. Most tumors are located in the orbital muscle cone, most of them are single, and very few are multiple. Most patients have no symptoms at an early stage, or only show unilateral progressive, painless eyeballs. Since about 80% is located inside the muscle cone, it is most common for the eyeball to protrude directly forward, and those outside the muscle cone can shift the eyeball. Vision is generally unaffected, but in a few cases with longer duration and larger tumors, vision can be severely impaired. Early eye movements are usually unaffected, and late stage eye movement disorders can occur. Tumors in the orbital apex can cause optic disc edema, optic nerve atrophy, or choroidal folds due to tumor compression. This tumor is located in the orbit, has cysts, and progresses slowly. Symptoms, signs and images are representative of benign tumors. The treatment of cavernous hemangioma is mainly surgical resection, and the prognosis is good.