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Wardhana DPW, Awyono S, Lauren C, Muhammad Rosyidi R, Saputra H. Intraparenchymal cerebellar capillary hemangioma in a 32-year-old man: a case report. Front Surg 2023; 10:1141522. [PMID: 37228758 PMCID: PMC10203496 DOI: 10.3389/fsurg.2023.1141522] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023] Open
Abstract
The authors present an unusual case of a 32-year-old adult male with a capillary hemangioma, which developed within the left cerebellar parenchyma. The histopathological examination reveals a mass mostly formed by the proliferation of capillaries, lined by a layer of flat-plump endothelial cells, some branching and dilating large capillaries, forming a lobulated structure separated by fibrocollagenous connective tissue. Immunohistochemistry examination with CD31 and S100 was positive on the endothelial and stromal cells, respectively, and negative S100 on the endothelial cells. Although rare, capillary hemangioma should be one of the differential diagnoses for diagnosing intra-axial lesions in the cerebellar region. Confirmation of the histopathological characteristic is necessary to determine the diagnosis of capillary hemangioma and exclude other differential diagnoses.
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Affiliation(s)
- Dewa Putu Wisnu Wardhana
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Academic Hospital of Universitas Udayana, Universitas Udayana,Badung, Indonesia
| | - Steven Awyono
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Universitas Udayana,Denpasar, Indonesia
| | - Christopher Lauren
- Neurosurgery Division, Department of Surgery, Faculty of Medicine, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Universitas Udayana,Denpasar, Indonesia
| | - Rohadi Muhammad Rosyidi
- Department of Neurosurgery, West Nusa Tenggara General Hospital, Medical Faculty of Mataram University,Mataram, Indonesia
| | - Herman Saputra
- Department of Anatomical Pathology, Faculty of Medicine, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Universitas Udayana,Denpasar, Indonesia
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2
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Kopecky A, Rokohl AC, Gaca PJ, Matos PAW, Nemcansky J, Heindl LM. Clinical Signs for Differential Diagnosis of Eyelid Tumours. Klin Monbl Augenheilkd 2023; 240:13-23. [PMID: 36706766 DOI: 10.1055/a-1996-0950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This article aims to present the differential diagnostics of benign and malignant eyelid tumours. The most common malignant eyelid tumour is basal cell carcinoma, followed by squamous cell carcinoma. The common signs of malignity are loss of lashes, ulceration, and infiltration of the lesion. Often the clinical appearance is various and therefore only a histological analysis gives the proper diagnosis. For most tumours, surgical resection is the gold standard of therapy. The reconstruction of the defects should be performed by an experienced oculoplastic surgeon. In malignant tumours that require large safety margins, the defect can be easily very large, and the reconstruction must then be performed with advanced ophthalmic plastic reconstruction techniques.
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Affiliation(s)
- Adam Kopecky
- Ophthalmology Clinic, University Hospital Ostrava, Ostrava, Czech Republic.,Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.,Department of Craniofacial Surgery, University of Ostrava Faculty of Medicine, Olomouc, Czech Republic
| | | | - Piotr Jakub Gaca
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | | | - Jan Nemcansky
- Ophthalmology Clinic, University Hospital Ostrava, Ostrava, Czech Republic.,Department of Craniofacial Surgery, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Ludwig M Heindl
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.,Center for Integrated Oncology (CIO) - Aachen - Bonn - Cologne - Düsseldorf, Cologne, Germany
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3
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Takahashi Y, Vaidya A, Kakizaki H. Improvement of Orbital Intramuscular Hemangioma Following Delivery. Ophthalmic Plast Reconstr Surg 2022; 38:e183-e186. [PMID: 35792735 DOI: 10.1097/iop.0000000000002237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 34-year-old primigravida woman at 26-week gestation presented with gradually progressive right eye proptosis since the early stage of pregnancy. On the first examination, the right eye had 7 mm proptosis, compared with the left eye. Magnetic resonance images demonstrated enlarged inferior and medial recti muscles with tendon involvement. The results of pathological examination of a specimen harvested from the medial rectus muscle lesion 1 month after the delivery corresponded to an intramuscular cavernous hemangioma. Three months after biopsy, the right eye had a 3-mm reduction in proptosis, and magnetic resonance images showed slight reduction in size of the medial rectus muscle lesion. The maximum diameter of the right medial rectus muscle measured on axial images decreased from 13.13 to 9.38 mm. The patient underwent balanced orbital decompression 8 months after the biopsy. At 9-month post-decompression period, the right eye had 3.5-mm proptosis, and the vision was stable.
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Affiliation(s)
- Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Aric Vaidya
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Kirtipur Eye Hospital, Kathmandu, Nepal
| | - Hirohiko Kakizaki
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan
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4
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Nair JR, Syed R, Chan IYM, Gorelik N, Chankowsky J, del Carpio-O'Donovan R. The forgotten lacrimal gland and lacrimal drainage apparatus: pictorial review of CT and MRI findings and differential diagnosis. Br J Radiol 2022; 95:20211333. [PMID: 35522773 PMCID: PMC10996330 DOI: 10.1259/bjr.20211333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/05/2022] Open
Abstract
The lacrimal gland is a bilobed serous gland located in the superolateral aspect of the orbit. Lacrimal system pathologies can be broadly divided into pathologies of the lacrimal gland and those of the nasolacrimal drainage apparatus. These include distinct congenital, infectious, inflammatory, and benign, indeterminate, and malignant neoplastic lesions. Trauma and resultant fractures affecting lacrimal drainage apparatus is not part of this review; only non-traumatic diseases will be discussed. CT is the initial modality of choice because of its ability to delineate lacrimal system anatomy and demonstrate most lacrimal drainage system abnormalities and their extent. It also assesses bony architecture and characterizes any osseous changes. MRI is helpful in further characterizing these lesions and better assessing involvement of the surrounding soft tissue structures. In this pictorial review, we will review the anatomy of the lacrimal system, describe CT/MRI findings of the common and uncommon lacrimal system abnormalities and discuss relevance of imaging with regards to patient management.
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Affiliation(s)
- Jaykumar Raghavan Nair
- Department of Diagnostic Radiology, McGill University Health
Centre, Montreal, Quebec,
Canada
- St. Michael’s Hospital,
Toronto, Ontario, Canada
- Department of Medical Imaging, University of
Toronto, Toronto, Ontario,
Canada
- Temerty Faculty of Medicine, University of
Toronto, Toronto, Ontario,
Canada
| | - Raza Syed
- Temerty Faculty of Medicine, University of
Toronto, Toronto, Ontario,
Canada
| | | | - Natalia Gorelik
- Department of Diagnostic Radiology, McGill University Health
Centre, Montreal, Quebec,
Canada
| | - Jeffrey Chankowsky
- Department of Diagnostic Radiology, McGill University Health
Centre, Montreal, Quebec,
Canada
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5
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Zvizdic D, Bulja D, Sidran A, Skenderi F, Zvizdic Z, Vranic S. Isolated deep orbital hemangioma treated successfully with oral propranolol in a 2-month-old infant: Case report with literature review. Am J Ophthalmol Case Rep 2021; 22:101095. [PMID: 33981915 PMCID: PMC8082548 DOI: 10.1016/j.ajoc.2021.101095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/07/2021] [Accepted: 04/12/2021] [Indexed: 12/01/2022] Open
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.
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Affiliation(s)
- Denisa Zvizdic
- Eye Clinic, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Deniz Bulja
- Department of Radiology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amila Sidran
- Pediatric Clinic, University Clinic Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Faruk Skenderi
- Department of Pathology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Zlatan Zvizdic
- Clinic of Pediatric Surgery, University Clinic Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
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6
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Rothschild BM, Zdilla MJ, Jellema LM, Lambert HW. Cribra orbitalia is a vascular phenomenon unrelated to marrow hyperplasia or anemia: Paradigm shift for cribra orbitalia. Anat Rec (Hoboken) 2020; 304:1709-1716. [PMID: 33135369 DOI: 10.1002/ar.24561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/12/2020] [Accepted: 10/20/2020] [Indexed: 02/03/2023]
Abstract
The orbital phenomenon, cribra orbitalia, has long been a source of controversy, especially with regard to its nature, derivation, and relationship to anemia. Therefore, the external surfaces of orbital roofs were systematically examined microscopically in human skulls from historical collections. Superior orbital surfaces of 278 individual crania within the Hamann-Todd collection were assessed at various magnifications using epi-illumination microscopy to identify the presence of cribra orbitalia and characterize its nature. Also, 12 additional individuals with diagnosed anemia in the Hamann-Todd collection were evaluated. Orbital roof alterations, present in one-third of examined crania, had two discrete appearances: Vascular grooves (45%) and application of new bone in a vascular branching pattern on the orbit surface (55%). Porosity of the orbit was not observed. Evaluation of the orbits of 12 individuals with diagnosed anemia revealed one with a single deep defect, suggesting a space-occupying phenomenon, but no evidence of bone accretion, vascular grooves, or porosity. Cribra orbitalia has often been lumped indiscriminately as an indicator of organismal stress, rather than identified as a indicating a specific etiology. Neither that perspective nor porosity are supported by high resolution examination of orbital roof changes. Recognition of the blood vessel imprint pattern falsifies previous speculations and provides a new paradigm. The actual character of cribra orbitalia is documented and new hypotheses generated. While population prevalence of cribra orbitalia seems excessive for explanation on the basis of these hypotheses, the imprints are clearly vascular in origin.
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Affiliation(s)
- Bruce M Rothschild
- Department of Vertebrate Paleontology, Carnegie Museum, Pittsburgh, Pennsylvania, USA
| | - Matthew J Zdilla
- Departments of Biology & Physician Assistant Studies, West Liberty University, West Liberty, West Virginia, USA.,Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University Anatomy Division, Morgantown, West Virginia, USA
| | - Lyman M Jellema
- Department of Physical Anthropology, Cleveland Museum of Natural History, Cleveland, Ohio, USA
| | - H Wayne Lambert
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University Anatomy Division, Morgantown, West Virginia, USA
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7
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Mehta A, Bajaj MS, Pushker N, Chawla B, Pujari A, Grewal SS, Grewal SPS, Singh SR, Kishore A, Yadav NS. To compare intralesional and oral propranolol for treating periorbital and eyelid capillary hemangiomas. Indian J Ophthalmol 2019; 67:1974-1980. [PMID: 31755431 PMCID: PMC6896529 DOI: 10.4103/ijo.ijo_59_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose: A pilot randomized control trial to compare the efficacy and side effects of intralesional and oral propranolol in periorbital and eyelid capillary hemangiomas. Methods: Twenty patients were prospectively randomized to two groups of ten each. Group 1 was initiated on oral propranolol 1 mg/kg/day titrated to final dose of 3 mg/kg/day over 1 week which was continued for 6 months and then tapered over 1 week; Group 2 received 3 doses of direct intralesional propranolol hydrochloride 1 mg/ml; 0.2 ml/cm 4–6 weeks apart. Hemangioma area and corneal astigmatism were measured. Results: Within each group at 6 months there was a significant reduction in area (group 1: 83.48 ± 11.67%, P = 0.0019; group 2: 67.78 ± 21.71%, P = 0.0019) and improvement in astigmatism (pre, post: group 1: 2.98D @ 179.8°, 1.13D @ 179.8°, P = 0.0045; group 2: 1.62D @ 90.16°, 0.75D @ 179.9°, P = 0.0001). There was no difference in area reduction (P = 0.056), change in appearance (P = 0.085), ptosis (P = 0.23) and side effects (lethargy, poor feeding; P = 0.171) between the two groups. Conclusion: Efficacy and side effects with intralesional propranolol are comparable to oral propranolol for periorbital and eyelid lesions.
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Affiliation(s)
- Aditi Mehta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi; Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mandeep S Bajaj
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neelam Pushker
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bhavna Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sartaj S Grewal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi; Department of Ophthalmology, Grewal Eye Institute, Chandigarh, India
| | | | - Simar Rajan Singh
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Alisha Kishore
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Singh Yadav
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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8
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Satterfield KR, Chambers CB. Current treatment and management of infantile hemangiomas. Surv Ophthalmol 2019; 64:608-618. [PMID: 30772366 DOI: 10.1016/j.survophthal.2019.02.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 01/27/2019] [Accepted: 02/04/2019] [Indexed: 12/19/2022]
Abstract
Infantile hemangiomas, otherwise known as infantile capillary hemangiomas, strawberry hemangiomas, or strawberry nevi, are nonmalignant vascular tumors that commonly affect children. The natural disease course typically involves growth for up to a year, followed by regression without treatment over a period of years with no cosmetic or functional sequelae. Less commonly, however, infantile hemangiomas can become a threat to vision or even life depending on location and size of the lesion. In addition, infantile hemangiomas, particularly those involving the face, may be disfiguring and result in lifelong sequelae. β-blockers have become a mainstay of therapy given their relatively low-risk profile and efficacy. Other treatment modalities previously described in the literature include corticosteroids (both intralesional and systemic), imiquimod, vincristine, bleomycin A5, and interferon α. More recently, angiotensin-converting enzyme inhibitors such as captopril have been used. Laser therapy and, less commonly, surgical excision are also available treatment options. We review current recommended management and treatment of capillary hemangiomas and discuss the benefits and risks of all previously reported treatment modalities.
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Affiliation(s)
- Kellie R Satterfield
- Department of Medicine, Scripps Mercy Hospital, San Diego, California, USA; Department of Ophthalmology, University of Washington, Seattle, Washington DC, USA
| | - Christopher B Chambers
- Department of Ophthalmology, University of Washington, Seattle, Washington DC, USA; Department of Oculoplastic and Reconstructive Surgery, University of Washington, Seattle, Washington DC, USA.
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9
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Effect of oral propranolol on periocular Capillary Hemangiomas of Infancy. Pediatr Neonatol 2018; 59:390-396. [PMID: 29301720 DOI: 10.1016/j.pedneo.2017.11.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 09/02/2017] [Accepted: 11/30/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To assess the safety and efficacy of oral propranolol in the management of periocular Capillary Hemangiomas of Infancy (CHI). METHODS Medical records of 21 infants diagnosed with periocular capillary hemangioma during a period of 5 years from 2009 to 2014 were retrospectively reviewed. The data collected included demographic details, clinical features and details of imaging studies and response to the therapy. All patients received oral propranolol under the supervision of a pediatrician. The initial dose was 0.2-1 mg/kg body weight, which was increased to 2 mg/kg body weight (3 divided doses) in 48 h if there was no adverse reaction to the initial dose. The response to the treatment was assessed clinically as well as by radiographic imaging. Photographic documentation was done periodically. RESULTS Out of 21 patients, 18 were females and remaining three were males. The median age at the time of presentation was 4 months. The most common presenting feature was lid mass (n = 17, 80%) followed by proptosis (n = 7, 33%). Reddish discoloration of face was seen in 2 (1%) patients. All patients showed reduction in the size of the lesion. None of the patients included in this study had any adverse reaction to propranolol or recurrence following cessation of the therapy. CONCLUSION Oral propranolol is highly effective and safe in the treatment of periocular capillary hemangiomas in infants.
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10
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Jenner ZB, Husein N, Riascos R, Esquenazi Y. Orbital and nasal meningoencephaloceles secondary to chronic hydrocephalus: A rare cause of bilateral proptosis. Neuroradiol J 2018; 31:420-425. [PMID: 29882488 DOI: 10.1177/1971400918778145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Orbital meningoencephalocele formation is primarily a result of congenital defects in the pediatric population and trauma of the anterior cranial fossa in adults. We present a unique case of nontraumatic nasal and orbital meningoencephaloceles presenting as bilateral proptosis with exotropia secondary to chronic hydrocephalus. Clinical presentation A 20-year-old male with a history of tuberous sclerosis, X-linked intellectual disability, and epilepsy presented to the emergency department with two days of nausea, emesis, seizures, and two months of progressive proptosis. Initial radiographs of the skull showed a "copper beaten" appearance, indicating chronically elevated intracranial pressure. Computed tomography imaging of the head demonstrated bilateral defects in the cribriform plate and anterior cranial fossa. Magnetic resonance imaging of the brain revealed triventricular hydrocephalus with meningoencephalocele extension into the nasal cavity and frontal horn herniation into the extraconal space of the orbits. The hydrocephalus was managed with ventriculoperitoneal shunt placement with rapid and complete resolution of the proptosis. Conclusion No reports have described bilateral proptosis as the presenting finding of orbital and nasal meningoencephaloceles in the absence of trauma or congenital defect. This case study demonstrates the management of meningoencephalocele formation secondary to chronic hydrocephalus.
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Affiliation(s)
- Zachary B Jenner
- 1 McGovern Medical School at The University of Texas Health Science Center, USA
| | - Nuruddin Husein
- 2 Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center, USA
| | - Roy Riascos
- 3 Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center, USA
| | - Yoshua Esquenazi
- 2 Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center, USA
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11
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Alsmman AH, Mounir A. Combined oral propranolol with intralesional injection of triamcinolone acetonide in treatment of infantile periocular hemangiomas. Clin Ophthalmol 2017; 11:2177-2181. [PMID: 29263646 PMCID: PMC5726359 DOI: 10.2147/opth.s153121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate the clinical effectiveness of combined oral propranolol with intralesional injection of triamcinolone acetonide in the treatment of infantile periorbital capillary hemangioma. Patients and Methods This prospective interventional study included children diagnosed with periocular infantile hemangiomas in the proliferative phase with vision-threatening lesions. The children presented to the oculoplastic unit in Sohag University Hospital in the period between January 2016 and February 2017 and were treated with a combined intralesional injection of triamcinolone acetonide with oral propranolol, with a follow-up period of 6 months. Treatment response was evaluated according to the size of the tumor (horizontal diameter); additionally, complications of both treatment methods were recorded. Results This study included 33 infants: 21 females (64%) and 12 males (36%). The mean age at the time of injection was 4.9±2.6 months. The study included three modes of treatment response: regression of the tumor, 28 patients (85%); stabilization, three patients (9%); and failure, two patients (6%), which necessitated repeated intralesional injection of triamcinolone but with minimal response. Regarding complications, only one patient reported with subconjunctival hemorrhage during intralesional injection of steroids; there were no recorded cases of hypotension, bradycardia, or hypoglycemia during the course of oral propranolol treatment. After the end of the follow-up period, there were no reported cases of recurrent increase in the size of the regressed group of infantile hemangiomas with stable tumor size. Conclusion Combined oral propranolol with intralesional injection of triamcinolone acetonide is the effective method of treatment for infantile periorbital capillary hemangioma with minimal adverse effects.
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Affiliation(s)
- Alahmady H Alsmman
- Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amr Mounir
- Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
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12
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Vijayanand S, Ranganatha N, Singh M, Babu R. Unusual Case of Acquired Capillary Hemangioma of the Eyelid in an Adult. Ann Maxillofac Surg 2017; 7:308-311. [PMID: 29264305 PMCID: PMC5717914 DOI: 10.4103/ams.ams_168_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Acquired capillary hemangioma of the eyelid is very uncommon in adults. To our knowledge, only eight such cases have been reported in the literature till date. We report the case of a 25-year-old female with acquired capillary hemangioma of the left lower eyelid treated by cutting diathermy followed by reconstruction of the cutaneous and cartilaginous defect. This patient had a history of a similar lesion in the left malar region treated 5 years back. This case is being presented to highlight the occurrence of such lesions in an adult and to discuss the dilemmas in the diagnosis and management.
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Affiliation(s)
- S. Vijayanand
- Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Narahari Ranganatha
- Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Madhumati Singh
- Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Ramesh Babu
- Department of Plastic Surgery, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
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13
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Strumila A, Kazlauskas V, Pošiūnas G, Verkauskas G, Beiša V. Infantile hemangioma: Predicting proliferation by infrared thermography. Medicina (B Aires) 2017; 53:85-89. [DOI: 10.1016/j.medici.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/19/2017] [Accepted: 04/06/2017] [Indexed: 01/17/2023] Open
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14
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Mohan A. Bilateral congenital infantile hemangioma of upper eyelids. Indian J Ophthalmol 2016; 64:542-3. [PMID: 27609170 PMCID: PMC5026085 DOI: 10.4103/0301-4738.190168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Amit Mohan
- Department of Pediatric Ophthalmology and Strabismus, Global Hospital Institute of Ophthalmology, Sirohi, Rajasthan, India
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15
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Schmitzer S, Butea-Simionescu C. VASCULAR ORBITAL TUMORS AT THE EXTREMES OF THE AGE SPECTRUM. Rom J Ophthalmol 2015; 59:59-62. [PMID: 27373118 PMCID: PMC5729815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 06/06/2023] Open
Abstract
Vascular orbital lesions are rare and, due to the controversy surrounding their origin, frequently difficult to diagnose. Studies showed that approximately 10% of orbital space-occupying lesions are of vascular origin. The most frequent are capillary hemangioma in children and cavernous hemangioma, which, although congenital, reveals itself in adults. Two cases of vascular tumors in patients, at the extremes of the age spectrum are presented.
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Affiliation(s)
- Speranta Schmitzer
- Clinical Emergency Eye Hospital, Bucharest, Romania
- OFTALMESTET Clinic, Bucharest, Romania
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Harikrishna B, Ganesh A, Al-Zuahibi S, Al-Jabri S, Al-Waily A, Al-Riyami A, Al-Azri F, Masoud F, Al-Mujaini A. Oral propranolol for the treatment of periorbital infantile hemangioma: a preliminary report from oman. Middle East Afr J Ophthalmol 2012; 18:298-303. [PMID: 22224018 PMCID: PMC3249815 DOI: 10.4103/0974-9233.90131] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: To investigate the efficacy and safety of oral propranolol in the management of periorbital infantile hemangioma in four subjects. Materials and Methods: Consecutive patients who presented with periorbital capillary hemangioma with vision-threatening lesions were prospectively enrolled in this study between January 2009 and October 2010. All subjects underwent treatment with 2 mg/kg/day oral propranolol. All subjects underwent ocular, systemic, and radiologic evaluations before treatment and at periodic intervals after starting therapy. Side effects from therapy were also evaluated. Results: Four subjects, between 3 months and 19 months of age, with periorbital hemangioma were enrolled in this study. Two subjects had been previously treated with oral corticosteroids with unsatisfactory response. All subjects had severe ptosis, with the potential for deprivation amblyopia. Three subjects had orbital involvement. After hospital admission, oral propranolol was initiated in all subjects under monitoring by a pediatric cardiologist. Subsequent therapy was performed with periodic out-patient monitoring. All subjects had excellent response to treatment, with regression of periorbital and orbital hemangioma. There were no side effects from therapy. Conclusions: Oral propranolol for periorbital hemangioma was effective in all the four subjects. Oral propranolol may be appropriate for patients who are nonresponsive to intralesional or systemic steroids. In patients with significant orbital involvement and lesions causing vision-threatening complications, oral propranolol can be the primary therapy.
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Affiliation(s)
- Beena Harikrishna
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
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