Articles Tập 67 Số CĐ13-HNKH Bệnh viện 19-8 09/09/2026

POSTORBITAL CAVERNOUS VENOUS MALFORMATION: CHALLENGES IN DIAGNOSIS AND FOLLOW-UP STRATEGY

Nguyen Le Ngoc Khanh1,2, Nguyen Ho Viet Lien3,4, Phan Nha Uyen5,6, Nguyen Thi Thu Huong1,2, Nguyen Thi Bich Huong7,8
1 Vinmec-Alina Eye Center, Vinmec Times City International General Hospital, Hanoi
2 Trung tâm Mắt Vinmec - Alina, Bv Đa khoa Quốc tế Vinmec Times City, Hà Nội
3 Saigon Eye Hospital (Cach Mang Thang Tam Branch), Ho Chi Minh City
4 Bệnh viện Đa khoa Mắt Sài Gòn Cách Mạng Tháng Tám, TP HCM
5 Eye Center – Hue Central Hospital, Hue City
6 Trung tâm Mắt-Bệnh viện Trung ương Huế, TP Huế
7 Department of Ophthalmology – Quang Ninh Provincial General Hospital
8 Khoa Mắt – Bệnh viện đa khoa tỉnh Quảng Ninh
DOI: 10.52163/yhc.v67iCD13.6500
0 Views
0 Downloads
Keywords
cavernous venous malformation, cavernous hemangioma, orbit, intraconal, MRI, observation
Abstract

Objectives: Orbital cavernous venous malformation (CVM), historically termed cavernous hemangioma, is a slow‑flow vascular lesion in adults. Intraconal lesions close to the optic nerve may threaten vision and pose a dilemma between observation and intervention.

Case report: A 45‑year‑old woman was incidentally found in 2022 to have a left intraconal retrobulbar lesion measuring 5.8 × 6.6 × 7.8 mm. She reported mild blurred vision without pain or diplopia. MRI showed a well‑circumscribed T2‑hyperintense lesion with strong post‑contrast enhancement, without clear optic nerve compression or adjacent tissue infiltration, consistent with CVM. The patient was managed conservatively with 6‑monthly clinical and imaging follow‑up. By March 2025, lesion size remained stable, with a mild decline in visual acuity.

Conclusions: MRI is pivotal for diagnosis and risk stratification of orbital vascular lesions. Structured surveillance is appropriate for small, minimally symptomatic intraconal CVM without compressive features, while functional visual monitoring is essential to promptly reassess the need for intervention.

References
[1]
1. Calandriello L, Gr1. Calandriello L, Grimaldi G, Petrone G, Rigante M, Petroni S, Riso M, Savino G. Cavernous venous malformation (cavernous hemangioma) of the orbit: Current concepts and a review of the literature. Survey of Ophthalmology. 2017;62(4):393-403. Google Scholar
[2]
DOI: 10.1016/j.survophthal.2017.01.004 Google Scholar
[3]
Đường dẫn: https://doi.org/10.1016/j.survophthal.2017.01.004 Google Scholar
[4]
2. Rootman DB, Heran MKS, Rootman J, White VA, Luemsamran P, Yucel YH. Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature. British Journal of Ophthalmology. 2014;98(7):880-888. Google Scholar
[5]
DOI: 10.1136/bjophthalmol-2013-304460 Google Scholar
[6]
Đường dẫn: https://doi.org/10.1136/bjophthalmol-2013-304460 Google Scholar
[7]
3. Longhim ACLV, Chahud F. Biological identity of orbital cavernous venous malformations. Arquivos Brasileiros de Oftalmologia. 2024;87(2):e2023-0338. Google Scholar
[8]
DOI: 10.5935/0004-2749.2023-0338 Google Scholar
[9]
Đường dẫn: https://doi.org/10.5935/0004-2749.2023-0338 Google Scholar
[10]
4. Xian J, Zhang Z, Wang Z, et al. Evaluation of MR imaging findings differentiating cavernous haemangiomas from schwannomas in the orbit. European Radiology. 2010;20(9):2221-2228. Google Scholar
[11]
DOI: 10.1007/s00330-010-1774-y Google Scholar
[12]
Đường dẫn: https://doi.org/10.1007/s00330-010-1774-y Google Scholar
[13]
5. Aymard PA, Langlois B, Putterman M, Jacomet PV, Morax S, Galatoire O. Management of orbital cavernous hemangioma - Evaluation of surgical approaches: Report of 43 cases. Journal Français d'Ophtalmologie. 2013;36(10):820-829. Google Scholar
[14]
DOI: 10.1016/j.jfo.2013.04.009 Google Scholar
[15]
Đường dẫn: https://doi.org/10.1016/j.jfo.2013.04.009 Google Scholar