A 45-year-old woman reports slowly increasing right-sided proptosis over two years. There is no pain, and imaging shows a well-circumscribed intraconal mass that causes an axial displacement of the globe. What is the most likely diagnosis?
- A Pleomorphic adenoma of the lacrimal gland
- B Orbital lymphoma
- C Cavernous haemangioma ✓
- D Optic nerve glioma
Correct answer: C. Cavernous haemangioma
Explanation
Cavernous haemangioma is the most common benign orbital tumour in adults. It is an intraconal vascular malformation producing slowly progressive, painless axial proptosis, often with hyperopic shift, and is well encapsulated on imaging. Lymphoma is typically superior or lacrimal fossa based in older patients, lacrimal pleomorphic adenoma is superotemporal extraconal, and optic nerve glioma is seen mainly in children with neurofibromatosis type 1.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.