Journal List > J Korean Ophthalmol Soc > v.55(7) > 1009733

Kim, Ahn, and Lew: A Case of Intramuscular Muller Muscle Hemangioma of Upper Eyelid Mimicking Sarcoidosis

Abstract

Purpose

We report a case of Muller muscle intramuscular hemangioma in the upper eyelid mimicking dacryoadenitis.

Case summary

A 21-year-old male patient presented with a 2-year history of upper eyelid swelling in his right eye and no symptom relief with oral corticosteroid. Increased angiotensin-converting enzyme (ACE) was noted in the laboratory findings. However, lid inflammation was not improved and the patient underwent incisional biopsy.

Conclusions

Microscopically, the lesion was composed of proliferating vessels of various sizes between the individual smooth muscle fibers. Intramuscular hemangioma rarely presenting as a benign tumor in the head and neck region can present as diffuse swelling mimicking sarcoidosis or dacryoadenitis.

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Figure 1.
(A, B) Facial photographs show diffuse erythematous swelling in the right upper eyelid, and the enlarged lacrimal gland (arrow) was noted. (C) A congestive and inflamative lacrimal gland (arrow) was noted in physical examinations with upper eyelid eversion 2 weeks later. (D) He had recovery and no evidence of recurrence during the follow up period of 3 months.
jkos-55-1084f1.tif
Figure 2.
(A, B) Orbital CT scan with enhancement images show a mild enlargement and infiltration of right lacrimal gland. A tiny suspected hyperintensity lesion was noted at the right upper eyelid (arrow).
jkos-55-1084f2.tif
Figure 3.
Microscopic findings of intramuscular hemangioma. (A, B) Proliferation of small to medium sized blood vessels between the bundles of smooth muscle (H&E, × 100 (A), × 200 (B)). (C, D) Immunohistochemical stain for smooth muscle (smooth muscle actin stain) was positive (S.M.Actin, × 100 (C), × 200 (D)).
jkos-55-1084f3.tif
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