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Abstract
Purpose
To report a case of periorbital infantile capillary hemangioma treated with propranolol as a single therapy.
Case summary
A 3-month-old girl with a growing red-purple mass on the right lower eyelid visited our clinic. The patient was diagnosed with capillary hemagioma by imaging studies. The mass had grown rapidly, and the visual axis was obscured in the follow-up. Oral propranolol therapy was initiated at a starting dose of 0.17 mg/kg at 8-hour intervals. After 2 doses, the propranolol was doubled, and after another 2 doses, the daily dose of 0.67 mg/kg divided into 3 was maintained. Three days after the initiation of the treatment, the color of the hemangioma had changed from red-purple to light purple, and the hemangioma had softened. The hemangioma continued to respond well with no side effects in the following 10 months.
Figures and Tables
Figure 1
Clinical photographs. (A, B) Before the treatment, a large, raised, dome-shaped mass occupied almost the entire right lower eyelid of the patient. The reddish purple mass was firm and fairly well circumscribed with smooth surface. The visual axis of the right eye is completely obscured by the mass.
Figure 2
MRI. (A, B) Before the treatment, MRI with postcontrast fat-suppressed T1-weighted image shows well circumscribed, lobulated, intraorbital mass (arrow) of the entire right lower eyelid. The lesion enhancement is intense and homogenous. (A) Coronal view. (B) Axial view.
Figure 3
Color Doppler imaging of the nasal aspect of the right lower eyelid. (A) At the first visit, the image of the nasal aspect of the right lower eyelid demonstrated an intraorbital hypoechoic lesion (1.8 × 1.2 cm) with regular border and multiple intercalating networks of blood vessels within (arrow). (B) 3 months after the first visit, it was found that the size of the mass had increased (2.4 × 2.6 cm).
Figure 4
(A) 3 months after the initiation of the treatment, the hemangioma was found to have markedly decreased in size and to no longer obscure the visual axis. The mass softened, flattened and faded in color. (B) 10 months after the initiation of the treatment, MRI with postcontrast fat-suppressed T1-weighted axial image revealed that the tumor (arrow) had decreased in size.
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