Sclerosing cavernous hemangioma of the cavernous sinus mimicking congenital fibrosis of the extraocular muscles

A girl with a clinical presentation suggestive of unilateral congenital fibrosis of the extraocular muscles type 3 at 2 years of age years later developed progressive ophthalmoplegia and an afferent pupillary defect. Reimaging revealed a lesion diagnosed as a sclerosing cavernous sinus hemangioma with focal calcification. Cavernous sinus hemangioma is a rare, benign vascular malformation whose growth causes cranial nerve compression. Although frequently missed on routine neuroimaging, characteristic radiologic findings distinguish it from lesions such as meningioma.