1/21. Prepartum mixed type cavernous-capillary hemangioma arising in nevus flammeus.OBJECTIVE: Capillary hemangioma may appear de novo and involute during the first decade of life, but rarely during pregnancy. This study describes the clinical and histologic findings of an eyelid mixed type cavernous-capillary hemangioma arising in a nevus flammeus and discusses the differential diagnosis of this lesion. STUDY DESIGN: Clinicopathologic case report. INTERVENTION: A reddish, protruding eyelid mass arising from a nevus flammeus at the eyelid margin in a 26-year-old woman was monitored during her pregnancy. Postpartum, the mass was excised and examined histologically. RESULTS: The lobulated tumor recurred during the second pregnancy and partially regressed following delivery. It was composed of mixed elements of cavernous and capillary hemangioma that superficially resembled Kaposi sarcoma, set against the background of a nevus flammeus. CONCLUSION: The differential diagnosis of discrete prepartum vascular tumor arising in nevus flammeus includes mixed capillary-cavernous hemangioma, pseudo-Kaposi sarcoma, granuloma gravidarum, and angiodermatitis. A common stimulus during pregnancy may be the inciting factor for the development of these tumors.- - - - - - - - - - ranking = 1keywords = capillary (Clic here for more details about this article) |
2/21. Surgical excision of selected amblyogenic periorbital capillary hemangiomas.To report the successful surgical excision of well-circumscribed capillary hemangiomas of the eyelid and orbit inducing occlusion amblyopia in 2 cases with immediate improvement of the patient's symptoms. A 2-month-old girl was diagnosed with a massive, amblyogenic orbital tumor which was removed intact via an inferior transconjunctival orbitotomy after magnetic resonance imaging (MRI) revealed a well-defined mass filling the entire inferior orbit. Histopathologic examination confirmed the diagnosis of orbital capillary hemangioma. A 1-month-old girl developed occlusion amblyopia due to an enlarging subcutaneous tumor of the left upper eyelid. The discrete mass was excised via an eyelid crease approach and confirmed to be an eyelid capillary hemangioma. There were no short-term or long-term complications in either case. In both cases, immediate resolution of occlusion amblyopia and cosmetic disfiguration was achieved. The final visual acuities were 20/20 at 5 years in the first patient and 20/30 at 4 years follow-up in the second patient. Orbital and eyelid capillary hemangiomas can induce profound permanent amblyopia. If the tumor is well-circumscribed, confirmed with orbital imaging, then surgical excision, with immediate resolution of amblyogenic factors, can be considered as a treatment option.- - - - - - - - - - ranking = 1.1428571428571keywords = capillary (Clic here for more details about this article) |
3/21. High injection pressure during intralesional injection of corticosteroids into capillary hemangiomas.BACKGROUND: Intralesional injection of corticosteroids is an effective treatment for tumors of the head and neck. Complications are rare but include permanent loss of vision. We designed a study to investigate the mechanism for this complication. methods: Three fellowship-trained pediatric ophthalmologists participated in the study in a nonmasked fashion. Four patients received 5 separate treatment sessions of an intralesional injection of a 50-50 mixture of triamcinolone diacetate (40 mg/mL) and betamethasone sodium phosphate and betamethasone acetate (6 mg/mL) into capillary hemangiomas. Injection pressure was obtained in real time using a cannula designed for this purpose. Maximum pressure, mean pressure, and volume of corticosteroid were measured from each injection. RESULTS: A total of 71 injections (range, 8-33 injections per patient) was performed. The total volume of corticosteroid ranged from 0.9 to 2.1 mL. In 63 of 71 injections, the maximum pressure exceeded 100 mm Hg (range, 18.65-842.18 mm Hg). Each surgeon produced injection pressures greater than the systemic arterial pressures of each patient. CONCLUSIONS: Injection pressures exceeding the systemic arterial pressures routinely occur during intralesional injections of corticosteroids into capillary hemangiomas. Experienced surgeons participating in a nonmasked protocol were unable to prevent high injection pressures of corticosteroid. A sufficient volume of corticosteroid injected at high injection pressure would account for the embolization of corticosteroid particles into the ocular circulation from retrograde arterial flow. We recommend limiting the volume of corticosteroid and performing indirect ophthalmoscopy on all patients receiving injections of long-acting corticosteroids into the orbit and periorbital soft tissue.- - - - - - - - - - ranking = 0.85714285714286keywords = capillary (Clic here for more details about this article) |
4/21. Adrenal suppression and failure to thrive after steroid injections for periocular hemangioma.PURPOSE: To evaluate the effects of steroid injections for periocular capillary hemangioma on adrenal function and body composition. DESIGN: Noncomparative, interventional case series. PARTICIPANTS: Four patients with periocular hemangioma. methods: Four white female infants with sight-threatening periocular hemangiomata received a combination of steroid injections of triamcinolone and betamethasone. In the first 2 cases, injections were perilesional and in the other 2, intralesional. MAIN OUTCOME MEASURES: The infants were monitored by serial measurements of basal serum cortisol concentrations, responses to the Synacthen stimulation test, measurement of growth and of weight gain, and, in one case, more detailed anthropometric measures of body composition. RESULTS: Prolonged suppression of circulating serum cortisol concentrations and cortisol responses to the Synacthen stimulation test were noted in 3 cases, and marked failure to thrive was noted in all 4 cases. CONCLUSIONS: Adrenal suppression after steroid injection for periocular capillary hemangioma is a potentially life-threatening complication. failure to thrive is also a frequent side effect of treatment. Ophthalmologists should undertake the above treatment in consultation with a pediatric endocrinologist.- - - - - - - - - - ranking = 0.28571428571429keywords = capillary (Clic here for more details about this article) |
5/21. The value of visual evoked potentials in the evaluation of periorbital hemangiomas.PURPOSE: To present a case of a child with an extensive facial hemangioma in whom the suspicion of intracranial involvement was raised by visual evoked potential (VEP) evaluation. DESIGN: Observational case report. methods: VEP analysis was performed using flash and pattern stimuli to determine whether treatment intervention other than occlusion therapy was needed. RESULTS: VEP analysis indicated a marked transoccipital asymmetry in the flash and pattern VEP suggestive of right hemispheric dysfunction. neuroimaging showed intracranial extension of the hemangioma. CONCLUSION: The VEP evaluation is a noninvasive technique performed in the awake child. This case highlights the usefulness of VEP analysis in the management of extensive periocular capillary hemangiomas and its use as a modality to identify potential intracranial involvement. Large plaquelike facial capillary hemangiomas may have possible underlying dural involvement suggestive of PHACES syndrome.- - - - - - - - - - ranking = 0.28571428571429keywords = capillary (Clic here for more details about this article) |
6/21. Adrenal suppression and growth retardation after injection of periocular capillary hemangioma with corticosteroids.Adrenal suppression and/or growth retardation were noted in two patients after injection of periocular capillary hemangiomas with corticosteroids. parents should be warned of these two potential complications of intralesional corticosteroid therapy. Baseline and posttreatment adrenal function should be monitored. If iatrogenic adrenal suppression occurs, supplemental systemic corticosteroids may be necessary in situations involving systemic stress such as infection or surgery.- - - - - - - - - - ranking = 0.71428571428571keywords = capillary (Clic here for more details about this article) |
7/21. Perilymphatic subcutaneous atrophy in adnexal hemangioma: a complication of intralesional corticosteroid injection.We report a case of atrophy of the perilymphatic, subcutaneous tissue following local steroid injection of an eyelid capillary hemangioma. Unlike such cases that have been previously reported, the atrophy in our case occurred after a single injection of triamcinolone. It spontaneously resolved over a period of 1 year. Although many cases of atrophy following local corticosteroid injections for other lesions elsewhere in the body have been reported, the entity we describe is a rare complication in capillary hemangioma therapy.- - - - - - - - - - ranking = 0.28571428571429keywords = capillary (Clic here for more details about this article) |
8/21. Eyelid necrosis following intralesional corticosteroid injection for capillary hemangioma.The intralesional injection of corticosteroids has been employed successfully in treatment of adnexal neonatal hemangiomas since 1979. This form of treatment is easily administered, is repeatable and free from serious complications. We present an exceptional case in which full-thickness eyelid necrosis ensued following intralesional injection of corticosteroids in a capillary hemangioma. After eyelid reconstruction the patient's visual axis has remained unobstructed, and amblyopia has been thus far averted.- - - - - - - - - - ranking = 0.71428571428571keywords = capillary (Clic here for more details about this article) |
9/21. Intralesional corticosteroid injections for infantile hemangiomas of the eyelid.Infants with capillary hemangiomas of the eyelid are at risk for amblyopia and strabismus. Several methods of treating these tumors have been associated with complications and limitations. The use of intralesional corticosteroid injections has been demonstrated to be a simple, safe, and effective method of treating capillary hemangiomas of the eyelid.- - - - - - - - - - ranking = 0.28571428571429keywords = capillary (Clic here for more details about this article) |
10/21. Small lymphangiomas of the eyelids.Three patients are described with focal lymphangiomatous lesions of their eyelids. A child with a partially regressed, congenital lesion presented with evidence of recent hemorrhage, while, of two adults with acquired tumors, one had a blue lesion suggesting a malignant melanoma, and the other had a more obviously cystic lesion, suggesting an epidermal or adnexal cyst. In one case, the lesion was situated entirely within the marginal orbicularis striated muscle, and in the other two cases the lesion was restricted to the dermis of the lid. Abrupt change in the coloration of a lesion in the lid should suggest hemorrhage into a preexistent tumor. hemorrhage into lymphangiomas is extremely common, and therefore this vascular tumor should be included in the differential diagnosis of previously nondiscolored lesions. Other vascular tumors, such as capillary, cavernous or venous angiomas would be expected to have a longstanding reddish-blue hue.- - - - - - - - - - ranking = 0.14285714285714keywords = capillary (Clic here for more details about this article) |
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