Periocular capillary hemangiomas: Indications and options for treatment

Abstract

Capillary hemangiomas are the most common periocular and orbital tumors of childhood that typically arise in infancy. Though the diagnosis is frequently made on clinical examination, various diagnostic modalities may be helpful in initial evaluation and follow-up. Tests may be necessary in diagnosing suspect cases or aid in the differentiation of potential malignant tumors. In the vast majority of cases these tumors undergo spontaneous involution without sequelae. However, some periocular and orbital capillary hemangiomas require intervention to prevent serious complications. Other tumors require treatment to lessen the surgical burden for cosmetic repair. When treatment is necessary, there are a number of therapeutic options available. As there is no standard, potential risks and benefits must be discussed with the family and treatment should be specific in each case. A complete understanding of the natural history of the tumor, indications for treatment, and response to different therapies is imperative in managing this common lesion.

Unusual case of acquired capillary hemangioma of the eyelid in an adult

“…[ 10 ] Ultrasonography scan shows an irregular mass with variable echoes blending into surrounding tissues and is used to rule out orbital involvement and to monitor the size of the lesion. [ 15 ] On CT scan, capillary hemangiomas appear as homogeneous soft-tissue masses without destruction of the underlying bone. [ 15 ] The use of contrast CT and MR imaging helps in delineating the border and identifying the feeder vessels.…”

“…[ 15 ] On CT scan, capillary hemangiomas appear as homogeneous soft-tissue masses without destruction of the underlying bone. [ 15 ] The use of contrast CT and MR imaging helps in delineating the border and identifying the feeder vessels. [ 15 ] 3D CT VRT can be used to delineate the fine anatomical details which are difficult to evaluate with axial reconstructions alone.…”

“…[ 15 ] The use of contrast CT and MR imaging helps in delineating the border and identifying the feeder vessels. [ 15 ] 3D CT VRT can be used to delineate the fine anatomical details which are difficult to evaluate with axial reconstructions alone. Angiography is rarely used to identify the feeder vessels for ligation or embolization in life-threatening hemangiomas unresponsive to other therapies.…”

“…Angiography is rarely used to identify the feeder vessels for ligation or embolization in life-threatening hemangiomas unresponsive to other therapies. [ 15 ] Tissue biopsy may be rarely needed to differentiate the lesion from neoplastic and aggressive lesions. [ 15 ]…”

Bilateral congenital infantile hemangioma of upper eyelids

“…[ 2 ] Masking of hypoglycemic symptoms is valid in patients who are premature or not feeding well. [ 3 ] Few suggest monitoring of vital signs and glucose levels while titrating propranolol up to the final treatment dose. [ 4 ] Hence, constant monitoring by a pediatrician is needed when using propranolol because of the fatal side effects.…”