Primary intraosseous hemangioma of the orbit. Report of a case and review of literature.

Orbital intraosseous hemangiomas are rare entities, with only 15 previously reported. We review these and present our own. They are benign, vascular tumors, typically found in the frontal, ethmoid, or zygomatic bones. They tend to present in the 4th or 5th decades as a mildly painful orbital rim mass. Ocular findings may be absent or severe, including blindness. These tumors have characteristic, although not always present, roentgenologic features that differentiate them. Our case is unusual in that it is the oldest patient reported, demonstrates bilateral lesions, and did not exhibit classic x-ray findings. We report imaging these lesions with magnetic resonance imaging with nonspecific results. The pathology of orbital hemangiomas is presented, with the most common being the cavernous type. Because these tumors may bleed when entered, block excision with normal margins is the treatment of choice. Radiation therapy has specific indications for nonresectable lesions. Prognosis is uniformly good, if treated.