Resection of a huge tufted angioma of orbit and orbitocranial mesh reconstruction.

ABSTRACT

BACKGROUND AND STUDY AIMS: Tufted angiomas (TAs) are rare, benign vascular neoplasms of childhood mainly localized in the skin and subcutaneous tissues. TAs are progressive, slowly growing, and characteristically involve superficial or deep muscle fascia tissue. TAs are frequently seen before the age of 5 years (60 to 70%) and have no sex predominance. TA following pregnancy or TA among immunosuppressive drug users was rarely reported in literature. TA is extremely rare in patients older than 60 years. PATIENT A 73-year-old man presented with right eye pain, redness, burning sensation, swelling, and double vision. On physical examination, his right eye was protruding, hyperemic, and there was a supraorbital palpable mass extending to the lateral orbital wall. Cranial computed tomography and magnetic resonance imaging revealed a heterogeneously enhancing right intraorbital retrobulbar capsulated lesion with intracranial extension. The patient underwent surgery. TA was proven histopathologically. CONCLUSION: We report the first TA of the orbit with orbital and cranial bone destruction, frontotemporal extension, and loss of vision due to optic nerve compression. The surgical treatment and orbitocranial mesh reconstruction following neurosurgical gross total removal of the lesion is discussed. TAs should be considered in the differential diagnosis of intraorbital tumors. TAs usually persist throughout life but cause no serious symptoms when they are located in the upper thorax, neck, and shoulders. TAs located in the orbit should be excised.