29-year-old female with orbital mass found an outside hospital. Headaches, orbital lesion found incidentally on outside hospital CT. There is a well demarcated, ovoid lesion in the right intraconal space which is superior and lateral to the optic nerve and produces mild inferior displacement of the lateral rectus. On T2-weighted sequences, a fluid-fluid level is noted with a rim of susceptibility along the anterior margin. Some enhancement of the posterior aspect of the lesion is suspected with a contrast level corresponding to the fluid/fluid level seen on T2 images. This lesion produces mild proptosis on the right. The right extraconal space and globe are normal. The left orbit is normal.There is a focus of increased T1 signal posterior to the right mastoid air cell along the tentorium which suppresses on fat-suppressed images. No significant enhancement this lesion is evident. Brain parenchyma appears otherwise unremarkable. The ventricles and basal cisterns are grossly normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact.
1.Enhancing lesion in the right intraconal space with a fluid fluid level is suggestive of a vascular lesion. A venous or venolymphatic malformation is favored with a hemangioma considered less likely.2.Incidental lesion along the right tentorium has signal suggestive of fat. Differential includes a small lipoma or dermoid, among other benign etiologies.