An unusual case of infantile orbital hemangioma affecting the superior rectus muscle
Author: Hugo Gonzalez Valdivia
Base Hospital / Institution: Hospital Sant Joan de Deu
ePoster presentation
Abstract ID: 24-269
Purpose
We present an infrequent case of orbital IH affecting superior rectus muscle (SRM), an atypical location.
Methods
A 4-month-old boy is presented in ophthalmology department from pediatric primary care for a little vascular lesion situated in the bulbar region under the right upper eyelid. In the physical exploration he presented a small purplish mass located in the posterior part of the right upper eyelid with a morula-shaped vascular appearance.
No restrictions were found in ocular motility, no proptosis, and the anterior segment and fundoscopy were completely within normality.
An MRI was performed obtaining T1 and T2 sequencies with and without fat suppression as well as diffusion images (b=1000). A dynamic study with contrast administration was performed and T1 fat suppressed images were acquired.
An intramuscular lesion was noted in the superior rectus of the right eye of 16 x 14 x 16 mm. The lesion was homogenous, hypointense in T1 weighted images, hyperintense in T2 sequences with a hypointense rim corresponding to a pseudocapsule. In the dynamic study, an arterial curve was noted as well as a homogeneous enhancement in the postcontrast sequences
Results
When the child was 9-month-old, the biopsy under general anesthesia was made. The histopathological findings consist in lesion proliferation of small vascular structures, some slit-shaped and covered by a single layer of prominent endothelial cells, with low mitotic activity. Skeletal muscle tissue and adipose tissue are not recognized. Vascular endothelium show positivity for CD34, GLUT-1 and WT-1.
Clinical, radiological and anatomopathological features were compatible with the diagnosis of orbital IH affecting the SRM.
Conclusion
We report, in the best of our knowledge, the first case report of an orbital IH affecting an extraocular muscle. The peculiarity of our case includes the location, the behaviour, being stable during several month without changing in size, and the results of the biopsy and IHC, that showed a IH and none an intramuscular hemangioma, a very rare entity.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Rachid | Bouchikh-El Jarroudi | Hospital Sant Joan de Deu |
| Ester | Casas Gimeno | Hospital Sant Joan de Deu |
| Joan | Prat Bartomeu | Hospital Sant Joan de Deu |
