Cavernous Haemangioma of Eyelid

Cavernous Haemangioma of Eyelid is a hamartoma, which arises usually after the second decade of life. Eyelid lesion is less common as compared to orbital tumour. It usually accompanies the orbital tumour and the occurrence of isolated eyelid lesion is rare.

Sinusoidal haemangioma, a subtype of cavernous haemangioma, involves eyelid with aggressive growth pattern. It invades adjacent eyebrow and cheek.

Blue rubber bleb naevus syndrome, a rare entity, is characterised by multiple cutaneous cavernous haemangiomas associated with gastrointestinal haemangiomas which often bleed.

 

References

Dutton Jonathan J, Gayre Gregg S, Proia Alan D. Diagnostic Atlas of Common Eyelid Diseases. Taylor & Francis Group, LLC 2007. P 128- 130.

Mannis Mark J, Holland Edward J. CORNEA – Fundamentals, Diagnosis and Management Fourth Edition. Elsevier Inc. 2017. P 325.

Pe’er Jacob, Singh Arun D. Clinical Ophthalmic Oncology- Eyelid and Conjunctival Tumors Second Edition. Springer-Verlag Berlin Heidelberg 2014. P 88- 89.

Othman Ihab Saad. Ophthalmic pathology interactive with clinical correlation. Kugler Publications, Amsterdam, The Netherlands, Ihab Saad Othman 2009. P 35- 36.

Bloom HJG, Lemerle J, Neidhardt MK, Voûte PA. Cancer in Children- Clinical Management. Springer- Verlag Berlin Heidelberg 1975. P134- 135.

Cavernous haemangioma may present with dark blue, compressible, lobulated lesion which increases slowly in size.

Large lesions may produce ptosis (drooping of upper eyelid) which may lead to amblyopia due to obstruction of visual axis or from astigmatism due to compression of eyeball.

 

Cavernous haemangioma represents hamartoma.

A hamartoma (developmental tumour) is a tumour like growth and it consists of disorganised group of cells and tissues normally found in the areas of growth in body.

Cavernous haemangioma of the eyelid, a rare acquired condition, is generally seen in adults. 

Clinically, superficial lesions are lobulated, compressible, dark blue coloured, and slowly progressive lesions. These lesions may produce amblyopia due to mass effect of ptosis or from astigmatism produced by ocular compression.

Histopathology:

Cavernous haemangiomas show endothelium lined, large dilated blood filled spaces. These vascular spaces are separated by fibrous stroma. These tumours are well circumscribed but are not encapsulated. There may be signs of focal chronic inflammation. There is no endothelial proliferation unlike acquired capillary haemangioma of eyelid. There may be thrombosis or foci of calcification.

Differential diagnosis:

The differential diagnosis includes

  • Acquired capillary haemangioma of eyelid
  • Arteriovenous malformation
  • Lymphangioma
  • Eyelid varix

 

Spontaneous regression of cavernous haemangioma has been reported, but it is more characteristic of capillary haemangioma.

Surgical therapy:

Surgical therapy by local excision may be required for lesions threatening amblyopia.

It may also be requested for cosmetic reasons.

Therapies such as intra-lesional sclerosing agents, cryotherapy, and fractionated doses of brachytherapy have been tried.
 

 

  • PUBLISHED DATE : Mar 28, 2018
  • PUBLISHED BY : NHP Admin
  • CREATED / VALIDATED BY : Dr. S. C. Gupta
  • LAST UPDATED ON : Mar 28, 2018

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