DOI: 10.36347/sjmcr.2020.v08i03.009

Pages: 298-299

The etiologies of a unilateral exophthalmos are multiple, rarely represented by an intra- or extra-conical vascular mass. Orbito-palpebralvaricose veins are rare (2% of orbital masses) and represent a major cause of unilateral intermittent exophthalmitis, often with an inflammatory character. We report a case of palpebral varices in a 45-year-old adult who underwent left orbital-facial contusion and who presented 2 months later a left-palpebral mass increasing in volume, extended to the left external canthus, associated with left exophthalmia intermittent, evolving for 6 months. Ophthalmologic examination revealed a moderate left ptosis with a left exophthalmia, non-axile, non-pulsatile, without thrill, painless, without complication, without visual deficit. A vascular mass is suspected on CT and MRI reveals a left palpebral varix with temporal extension, confirmed by ANGIO-MRI. The latter also made it possible to eliminate differential diagnoses (tumor, arteriovenous fistula, etc.) and to look for a cerebral venous malformation, an encephalocele or an associated bone defect. Without complications, treatment with platelet antiaggregant at low preventive dose was undertaken before the indication of a surgical excision for aesthetic damage and extensiveness. In case of complication, sclerosis, or even excision of the varicose vein, would be possible with disappointing results (recurrence, hemorrhage).