A Large Infantile Capillary Hemangioma of the Eyelid with 5 Years Follow-up

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Dermatology

Background:

• Congenital eyelid masses can cause significant visual obstruction in infants.
• Early intervention is crucial for preserving vision and cosmesis.
• Treatment options for orbital tumors in neonates are varied and require careful consideration.

Observation:

• A five-day-old infant presented with a large right upper and lower eyelid mass.
• The mass completely obstructed the visual axis, posing a risk to vision.
• Initial treatment included intralesional triamcinolone acetonide under general anesthesia, with no observed tumor size change.

Findings:

• Systemic propranolol (1 mg/kg) was administered at three months of age.
• No significant reduction in tumor size was noted after two months of propranolol therapy.
• Surgical excision was performed, but the tumor demonstrated recurrence post-operatively.
• Neither intralesional triamcinolone acetonide nor oral propranolol showed efficacy in managing this eyelid tumor.

Implications:

• This case underscores the limited efficacy of non-surgical treatments like intralesional triamcinolone acetonide and oral propranolol for certain congenital eyelid tumors.
• Recurrence after surgical excision suggests the need for further investigation into the tumor's biology and potentially more aggressive or targeted therapeutic strategies.
• Further research is warranted to identify optimal management protocols for recurrent or refractory congenital eyelid masses to prevent long-term visual impairment.