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Orbital lymphangioma

Photo by Professor Chua Chung Nen

A 5-year-old girl was noted by her mother to have a right non-axial proptosis and hypertropia. An orbital scan revealed a mass lesion arising from the inferior extraconal space with extension into the intraconal space. The contents of the mass showed vascular component and old blood consistent with lymphangioma. An inferior orbitotomy was performed via a split lid approach. The lesion was excised from the extraconal space. Post-operatively, the patient showed marked improvement of the proptosis and reduction of the hypertropia.

 

 

 

Right hypertropia with non-axial proptosis.   Orbital scan showing vascular lesion in the inferior orbital space.   The scan also shows intraconal component.   Coronal scans showing the vascular lesion with clotted blood.   A split skin approach was performed. The fat prolapsed through the wound when the orbital septum was opened.   The vascular lesion could be visualized amid the orbital fat.   Excision of the lesion.   Post-excision.   Part of the wall of the excised lesion showing vascular spaces with old clotted blood.   Tube inserted to drain any orbital blood.   24 hours after the operation.   Appearance of the eye at five days post-operative.

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