A 35 year old male presented, suffering from night sweats, occipital and frontal headaches, blurred vision, nausea and a decrease in appetite. He underwent a CT and MRI scan, which identified a 2.2cm lesion in the left orbit in an intra-conal position. This was suspected to be a cavernous haemangioma, although other tumours, such as Schwannoma could not be ruled out.

A nuclear medicine labelled red blood cell study was performed which included initial dynamic images and early statics and 120min delayed images. SPECT/CT was also performed at the later time. The characteristic blood pool mismatch of low early and high delayed concentration of labelled red blood cells confirmed suspicions of a cavernous haemangioma, which, although comprised mainly of blood vessels, has slow flow. Hence there is considerable delay before maximum activity is reached.

The lesion was surgically removed. Histology reports confirmed the nuclear medicine results.

Nuclear Medicine has the potential to play a significant role in the preoperative diagnosis of an orbital mass.