Male, 70 years old, with left orbital mass, visual deficits and pale nerves on exam, would like to characterize lesion and optic nerve compression. A well demarcated, ovoid masslike lesion is evident within the posterior intraconal space of the left superolateral orbit. The lesion measures 12 x 9 x 9 mm. The lesion demonstrates patchy enhancement on the earliest postcontrast images with subsequent fill-in on later postcontrast images. The lesion contacts but does not infiltrate or significantly deform the superior rectus and lateral rectus muscles. The lesion also contacts and mildly displaces the optic nerve medially. The nerve does not appear to be significantly impinged, and no optic nerve signal abnormality is seen.No abnormalities of the right orbital structures are seen. The globes are round and symmetric. Bilateral lens replacement is noted. Mild patchy mucosal thickening of the visualized paranasal sinuses is seen.
An ovoid masslike lesion is evident occupying the upper outer aspect of the left intraconal space. The lesion exerts mild mass effect upon the optic nerve but without significant nerve compression. The imaging features of this lesion favor a benign cavernous hemangioma. Some other type of vascular anomaly, or even a nerve sheath tumor, would be less likely considerations.