An 8-year-old boy initially presented with an orbitopalpebral mass diagnosed clinically and radiologically as a low-flow diffuse venous lymphatic malformation involving the left upper eyelid and orbit. Over 8 months of follow up, he had 2 acute episodes of severe orbital inflammation that warranted hospitalization and treatment with intravenous antibiotic, steroids and surgical debulking. After a third surgical excision, the lesion remained clinically stable.