Although specific lesions are often present in certain locations within the orbit, significant variation may occur. A focused differential diagnosis minimizes the morbidity and cost of the diagnostic workup and helps establish the diagnosis effectively and efficiently. Specific elements of the history and the physical examination help establish a differential diagnosis, and the possible etiologies are further refined through appropriate imaging studies. In general, well-circumscribed lesions are more likely to be benign, such as a cavernous hemangioma, fibrous histiocytoma, lipoma, neurofibroma, schwannoma or neurilemmoma, and pleomorphic adenoma. Conversely, malignant tumors more commonly present with a diffuse infiltrative pattern.