A. Schlüter, K. Stock, R.P. Spielmann (Halle)  

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Head-Eye and orbita  

neoplastic  

Swelling in the area of the left obital roof. The findings were noticed initially in the 2nd month of life. Palpatory findings noted a good shifting/movement of the tumor. The skin in the region of the tumor was slightly discolored.  

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<- view MRI 1

MRI 1: T2 - Transversal
Proof of a mass in the region of the cranial orbital wall on the left side (preseptal in the area of the eyelid). It has a high signal with discrete granular characteristics.






<- view MRI 2

MRI 2: T1 native - Transversal
One sees a relatively hypointense signal.






<- view MRI 3

MRI 3: T1 with contrast - Transversal
After contrast application, obvious enhancement with discrete granular aspects.

Partial proof of tubular internal structures. No proof of intra- and extraconal lesions intraorbitally.




 

Total constellation (Consens)  

According to literature, the title of "benign hemangioendothelioma" is also used. A lymphangioma is first and foremost differential diagnosis to be discussed. A Rhabdomyosarcoma should generally be ruled out, whereas due to the possible infiltrative component of capillary hemangiomas, the sole differentiation through imaging may provide difficulties.
Further differential diagnoses are Neurofibromas, optic glioma, lymphomas, dermoid/epidermoids or an inflammatory pseudotumor. These lesions are usually able to be differentiated because of their localization, age characteristics and their imaging properties.

Caveat: Kasabach-Merritt Syndrome  

Capillary hemangiomas may show a fast growth in the first months of life. The prognosis is dependent on the responsive behavior to treatment. An infiltrative component makes surgical intervention difficult.

Capillary hemangiomas are the most common (peri)orbital space-consuming lesions in newborns and children (up to 2 years of age).

Hemangiomas make up about 12% of (peri)orbital tumors in children.  

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1. Medline:
Verma K, Verma KK
Infantile periocular haemangioma treated with two days in a week betamethasone oral mini pulse therapy
Indian J Pediatr (2001); 68; 355-6

2. Medline:
Bilyk JR, Adamis AP, Mulliken JB
Treatment options for periorbital hemangioma of infancy
Int Opthalmol Clin (1992) 32; 95-109  

Capillary, hemangioma, orbita, fast growing eye tumor, child, childhood, pediatric radiology  

A Schlüter, K Stock, RP Spielmann. Capillary hemangioma of the orbita. PedRad [serial online] vol 1, no. 11.
URL: www.PedRad.info/?search=20011112162934