title: Benign orbital angiomatous tumors with intracranial extension.
abstract: Orbital neoplasms with associated bone erosions and intracranial extension are generally considered suspicious for malignancies. Here, we describe the clinical and radiological findings, as well as the surgical management of two extraordinary cases, in which such bony perforations with subsequent intracranial tumor growth resulted from benign angiomatous orbital neoplasms. Two female patients, 69 years old (case 1) and 51 years old (case 2), had both developed visual symptoms (visual field restrictions and/or visual acuity loss) over several months. Computed tomography revealed an orbital tumor of the anterosuperior orbit with painless swelling of the medial upper eyelid of the right eye in case 1, and a posterior intraconal tumor close to the orbital apex of the left eye in case 2, respectively. In both cases, the tumor was associated with a perforation of the orbital roof connecting the orbit with the anterior cranial fossa. An interdisciplinary ophthalmologic and neurosurgical approach allowed for complete tumor removal, in both patients with no signs for local recurrence during the subsequent follow-up of 15 and 18 months, respectively, as well as for a satisfactory visual rehabilitation.
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, Germany. konrad.koch@uk-koeln.de.
authors.forename: Konrad R
authors.initials: KR
authors.lastname: Koch
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, Germany. mario.matthaei@uk-koeln.de.
authors.forename: Mario
authors.initials: M
authors.lastname: Matthaei
authors.affiliation: Department of Neurosurgery, University of Cologne, Cologne, Germany. stefan.grau@uk-koeln.de.
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Grau
authors.affiliation: Department of Neuropathology, University of Cologne, Cologne, Germany. tobias.blau@uk-koeln.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Blau
authors.affiliation: Department of Radiology and Radiooncology, University of Duesseldorf, Duesseldorf, Germany. boelke@med.uni-duesseldorf.de.|Department of Radiation Oncology, University of Duesseldorf, Duesseldorf, Germany. boelke@med.uni-duesseldorf.de.
authors.forename: Edwin
authors.initials: E
authors.lastname: Bölke
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, Germany. ole.schlichting@uk-koeln.de.
authors.forename: Ole
authors.initials: O
authors.lastname: Schlichting
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, Germany. claus.cursiefen@uk-koeln.de.
authors.forename: Claus
authors.initials: C
authors.lastname: Cursiefen
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, Germany. ludwig.heindl@uk-koeln.de.
authors.forename: Ludwig M
authors.initials: LM
authors.lastname: Heindl
mesh_terms: D000368:Aged; D000798:Angiomatosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000175:diagnosis*; D019291:Skull Base / Q000473:pathology*