Primary adnexal angiosarcoma masquerading as periorbital hematoma

• Published in: Survey of ophthalmology 2014-11, Vol.59 (6), p.655-659
• Main Authors: Lemanski, Nicole, MD, Farber, Martha, MD, Carruth, Bryant P., MD, Wladis, Edward J., MD, FACS
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; angiosarcoma; Biomarkers, Tumor - metabolism; Biopsy; Diagnosis, Differential; Eyelid Neoplasms - diagnosis; Eyelid Neoplasms - metabolism; Eyelid Neoplasms - surgery; Female; Hemangiosarcoma - diagnosis; Hemangiosarcoma - metabolism; Hemangiosarcoma - surgery; Hematoma - diagnosis; Hematoma - metabolism; Hematoma - surgery; Humans; Magnetic Resonance Imaging; Neoplasm Proteins - metabolism; Ophthalmologic Surgical Procedures; Ophthalmology; Orbital Diseases - diagnosis; Orbital Diseases - metabolism; Orbital Diseases - surgery; Parotid Neoplasms - diagnosis; Parotid Neoplasms - surgery; primary adnexal angiosarcoma; Radiotherapy, Adjuvant; Tomography, X-Ray Computed
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/j.survophthal.2014.06.005

Abstract We report an elderly woman who was anticoagulated and presented with a recent history of right-sided orbital contusion and a periorbital hematoma without clinical or radiological evidence of focal mass or orbital involvement. She was initially treated conservatively. Continued progression of adnexal swelling and erythema prompted further investigation, however. There was no improvement with surgical drainage alone; biopsy revealed angiosarcoma. The discovery of this vascular tumor underscores the importance of a reconsideration of the diagnosis in the face of counterintuitive findings. Additionally, we emphasize the need to consider malignancy in the differential diagnosis of prolonged periorbital swelling, regardless of a history of recent trauma.