The patient in the photos below is a 45 yo female with complaints of a bulging right eye that has been gradual over the past several years. She denies pain or double vision. Her CT scans are shown below as well as the surgical removal of the tumor. What is the most likely diagnosis?

Correct Answer: cavernous hemangioma

Cavernous hemangiomas are the most common benign orbital tumors in adults. The grow slowly over time but do not cause pain. Many which are stable in size and are not causing functional problems can be observed. Those that grow and begin to constrict the optic nerve or cause diplopia can be removed surgically, usually via a lateral orbitotomy, removing the lateral orbital rim and extracting with a cryo probe. Schwannomas are also benign lesions but have a tail extending from them. Capillary hemangiomas are usually present on the skin, but can extend into the orbit. They are not as well circumscribed. Metastatic carcinomas diffusely infiltrate the orbit, grow more rapidly and are often associated with pain.