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Answers: 2008 Series -  September 9, 2008 Lecture 17 of 53  NEXT»

To see views enlarged, click on the individual pictures...

Case14A
Fig. 1
Case14B
Fig. 2a
CAse14C
Fig. 2b

Photos courtesy of: Carol L. Shields, M.D.
Used with permission. Not to be reproduced.

A ten-month-old baby was brought for the management of an eye tumor in the left eye. The lesion was suddenly noticed at 4 weeks of age and has been growing gradually since then. He was born of cesarean section at 33 weeks due to pre-eclampsia. The child' s vision was following and fixing light well, with each eye. Motility was full in both eyes and there was no proptosis. Right eye was well within normal limits. Left eye is as shown in Fig. 1 above.

1. What is your presumptive diagnosis?

b -- capillary hemangioma

2. What is not true about the lesion?

c -- none of the above

  • Capillary hemangioma is common in eyelids, less common in orbit and uncommon in conjunctiva. This patient has both a mild lid and major conjunctival component. The capillary hemangioma typically appears in infancy, grows slowly and then slowly regresses. Systemic evaluation should be done to note similar lesions elsewhere in the body as shown above in Figure 2a and 2b. 
  • 20-25% of pre-mature patients are proved to have skin capillary hemangiomas.
  • Cavernous hemangioma is a red or blue lesion, fairly uncommon in conjunctiva.


REFERENCES:

1. Wright JF, Sullivan TJ, Garner A, et al. Orbital venous anomalies. Ophthalmology 1997: 104; 905-913

2.   Shields JA, Criss J, Mashayekhi A, et al. Vascular tumors of conjunctiva. IN PRESS



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