A 35-year-old woman with progressive proptosis has CT showing a well-circumscribed, smooth, ovoid intraconal orbital mass with homogeneous density that enhances uniformly. The MOST likely diagnosis is:

• A Orbital lymphoma
• B Dermoid cyst
• C Cavernous haemangioma (venous malformation) of the orbit ✓
• D Orbital metastasis

Explanation

Cavernous haemangioma (now classified as venous malformation) is the most common benign intraconal orbital tumour in adults, presenting with slowly progressive, painless, axial proptosis. CT shows a well-encapsulated, smooth ovoid mass with uniform enhancement. Dermoid cysts are usually extraconal, near the fronto-zygomatic suture, with fat density. Lymphoma shows irregular molding to orbital structures. Metastases tend to cause bony destruction and irregular enhancement.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.