DOI: https://doi.org/10.36347/sjmcr.2026.v14i06.030

Pages: 1446-1450

Anterior orbital cavernous hemangioma is a rare benign vascular malformation representing an unusual presentation of orbital cavernous venous malformations, which are more commonly located within the intraconal orbital space. We report the case of a 52-year-old woman presenting with a slowly progressive, painless swelling at the medial canthus of the right orbit evolving over one year. Ophthalmological examination revealed a bluish, non-pulsatile, non-inflammatory periocular mass without exophthalmos or visual impairment. Doppler ultrasonography demonstrated a well-circumscribed lesion with minimal vascular flow. Magnetic resonance imaging revealed a cystic-appearing lesion of the superomedial palpebral soft tissues, hyperintense on T2-weighted imaging and hypointense on T1-weighted imaging, with diffusion restriction and mild peripheral enhancement, initially suggesting an epidermoid cyst. Complete surgical excision was performed through an anterior orbital approach. Histopathological examination confirmed the diagnosis of cavernous hemangioma. The postoperative course was uneventful, with complete resolution and no recurrence. This case highlights the diagnostic challenges associated with atypical anterior orbital cavernous hemangiomas and emphasizes the importance of correlating clinical, radiological, and histopathological findings for accurate diagnosis and optimal management.