DR. ARNAB MANDAL

Dr. MOUSUMI BANERJEE, Dr. INDRAJIT SARKAR, Dr.Subhasis Jana

Abstract

A 5 years old male presented with sudden onset painful proptosis of left eye with fever since 7 days. After initial conservative treatment for 5 days as an orbital cellulitis, inflammation subsided & a soft bluish mass was noted at the superomedial aspect of the left eye, with down & out dystopia, proptosis, restrictive squint & diminished vision.

CT scan orbit shows lobulated mass lesion in retroorbital location extending to medial aspect of orbit, with no bony involvement. MRI orbit suggests complicated lymphangioma, heterogeneous collection inside, pushes left optic nerve more at medial aspect.

Aspiration of fluid from inside & partial debulking of the mass was done on 8th day after admission. HPE suggests vascular hamartomatous lesion.

Post-operatively, proptosis subsided with improvement of vision, eyeball movement & angle of deviation.

Spontaneous hemorrhage inside a lymphangioma may lead to sudden enlargement, orbital pain & diminished vision with formation of chocolate cyst.