Late-onset presentation of orbital lymphangioma

PURPOSE: To report a group of patients with biopsy-proven orbital lymphangioma diagnosed late in life. METHODS: The clinical records and histopathologic findings of 3 patients with biopsy-proven orbital lymphangioma were reviewed. RESULTS: Three patients were identified who were diagnosed with orbital lymphangioma at the ages of 70, 80, and 82 years old. Each patient presented with different symptoms and signs including presence of a superficial mass, periorbital pain, and gradual painless proptosis, respectively. In one case, imaging revealed an isolated superficial mass, and in the other 2 cases it demonstrated the presence of a heterogeneous, cystic, retrobulbar mass. Pathologic findings in all cases included endothelium-lined channels with intervening fibrous septae infiltrated with aggregates of lymphocytes. Two of the three patients had complete excisions without recurrences and the third patient was followed after biopsy. CONCLUSIONS: Lymphangioma, one of the most common vascular lesions in childhood, should also be included in the differential diagnosis of orbital masses in adults, including elderly adults.