Isolated deep orbital hemangioma treated successfully with oral propranolol in a 2-month-old infant: Case report with literature review

Abstract

Purpose Infantile hemangiomas (IH) are the most common benign vascular tumors of infancy. Ocular complications due to orbital IH include strabismal, deprivational, or anisometropic astigmatism, and visual loss secondary to amblyopia. Observations We report a case of a two-month-old female infant with a severe deep orbital IH. The diagnosis was established by clinical examination and magnetic resonance imaging (MRI). The patient was treated with oral propranolol for six months. Complete tumor regression was observed clinically and by MRI following the treatment. The patient showed no adverse effects or tumor recurrence at the 14-month follow-up. Conclusions and Importance Despite its benign nature, periorbital IH requires a rapid diagnosis and prompt treatment to prevent vision loss, particularly in infants. Our case confirms that oral propranolol may be regarded as a safe drug for periorbital IH with an excellent outcome.

Orbital Tumors—Clinical, Radiologic and Histopathologic Correlation

“…When capillary hemangioma appears as a mass of the orbit and periorbital areas, imaging is often necessary to assess the extent of the hemangioma and its possible effect on adjacent anatomical structures [ 48 ]. Aside from the involvement of extraconal structures like extra-ocular muscles and lacrimal glands, intracranial extension through the optic canal or superior orbital fissure can also be found [ 49 ]. Clinically, superficial, deep, and mixed lesions can be differentiated.…”