Large Orbital Pediatric Intraosseous Hemangioma

Abstract

A five-year-old male presenting with progressive right facial swelling underwent multiple biopsies before being diagnosed with a polyostotic frontal-zygomatic primary intraosseous hemangioma. Intraosseous hemangiomas are rare, more frequently afflict adult females, and very rarely involve the orbit. Our case with bony destruction and surrounding soft tissue mass measured 5.3 cm in a child mimicked a more ominous malignancy. This case is unique with its rapid progression and largest reported size, leading to additional challenges such as difficulty in achieving an adequate tissue sample and in the surgical management with respect to significant blood loss in a small child.

Successful Management of a Large Orbital Hemangioma in an Infant: A Case Report

“…Our case underscores the importance of early recognition, prompt referral to specialized centers, and initiation of appropriate therapy to optimize outcomes in affected infants. The diagnosis of orbital hemangiomas relies primarily on clinical presentation and imaging studies [2,4]. Classic features include progressive eyelid swelling, proptosis, and palpable mass, as demonstrated in our case.…”

“…Classic features include progressive eyelid swelling, proptosis, and palpable mass, as demonstrated in our case. Imaging modalities such as orbital ultrasound and magnetic resonance imaging play a crucial role in confirming the diagnosis, delineating the extent of the lesion, and assessing its relationship to surrounding structures [3][4][5][6].…”

“…Propranolol, a non-selective beta-blocker, has emerged as a first-line treatment for infantile hemangiomas due to its efficacy in promoting regression and minimizing potential complications [2]. Despite its widespread use, the precise mechanisms underlying the therapeutic effects of propranolol on orbital hemangiomas remain incompletely understood [2,4]. Furthermore, optimal dosing regimens, duration of treatment, and long-term outcomes of propranolol therapy in this population are areas of ongoing research and debate [1][2][3][4][5].…”

“…Despite its widespread use, the precise mechanisms underlying the therapeutic effects of propranolol on orbital hemangiomas remain incompletely understood [2,4]. Furthermore, optimal dosing regimens, duration of treatment, and long-term outcomes of propranolol therapy in this population are areas of ongoing research and debate [1][2][3][4][5]. In this context, we present a case of a six-month-old infant with a large orbital hemangioma treated with propranolol, highlighting the clinical presentation, diagnostic work-up, management, and long-term follow-up of this rare but clinically significant condition.…”

Hemangioma of the Mandible in a 12-Year-Old Boy

“…1 They are more common in adult females with peaks at the second and fifth decades of life. [1][2][3] Hemangioma of the mandible is difficult to diagnose due to its nonspecific clinical presentation and radiographic features. It mimics various mass lesions in the mandible such as giant cell granuloma, fibrous dysplasia, multiple myeloma, osteosarcoma, ameloblastoma and keratocysts.…”