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Diffuse neonatal hemangiomatosis presenting as bilateral iris hemangiomas in an infant
Stephen S Couvillion1, Charles C Wykoff, Jacqueline L Tutiven
1From the *Department of Ophthalmology, Bascom Palmer Eye Institute, and †Department of Anesthesiology, University of Miami Miller School of Medicine; and ‡Department of Hematology and Oncology, Joe DiMaggio Childrens Hospital, Hollywood, Florida.
Purpose:
To describe a case of diffuse neonatal hemangiomatosis presenting as bilateral iris hemangiomas.
Method:
Case report.
Patient:
A 2-month-old girl presented with bilateral enlarging red masses of her irises, congestive heart failure, and abdominal distension. The iris masses were diagnosed as hemangiomas, and she was found to have diffuse neonatal hemangiomatosis also involving her skin, liver, heart, and cerebellum.
Results:
The patient's systemic hemangiomas were successfully treated with four cycles of weekly intravenous vincristine (0.05 mg/kg/dose) with concurrent resolution of her right iris hemangioma within 6 weeks. The left iris lesion then regressed within 1 month following 1 subTenon injection of 20 mg of triamcinolone acetonide with residual iridocorneal adhesions at the site.
Conclusion:
Diffuse neonatal hemangiomatosis should be considered in the setting of bilateral iris hemangiomas. Also, this case demonstrates that iris hemangiomas associated with diffuse neonatal hemangiomatosis may respond to systemic vincristine, and that periocular steroids may be useful for treating iris hemangiomas that are unresponsive to systemic vincristine alone.
