A 45-year-old woman presents with intermittent proptosis that worsens on bending forward and during Valsalva manoeuvre. CT orbit shows a well-defined mass with phleboliths. The most likely diagnosis is:
- A Cavernous hemangioma
- B Orbital varix ✓
- C Neurofibroma
- D Lymphangioma
Correct answer: B. Orbital varix
Explanation
Orbital varix is a low-flow venous malformation that presents with intermittent proptosis worsened by Valsalva or dependent head position. Phleboliths on CT are virtually pathognomonic. Cavernous hemangioma causes progressive non-pulsatile proptosis without positional variation. Lymphangioma presents with intermittent hemorrhage or infection, not Valsalva-related change.
Reference: Orbit, Eyelids, and Lacrimal System (AAO Basic and Clinical Science Course), 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.