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Multifocal infantile hemangioma of the eyelid causing amblyopia requiring surgical resection
Kimberly Nguyen1, Aliza Epstein2, Donovan S Reed1,3
1Department of Ophthalmology, Dell Medical School, University of Texas, Austin, Texas.
Insights
A rare case of infantile hemangioma presented as multiple skin lesions and liver involvement. Surgical excision of an eyelid lesion was necessary to prevent vision loss.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
- Ophthalmology
Background:
- Cutaneous vascular lesions in infants are uncommon and can indicate diverse conditions.
- Accurate diagnosis is crucial for appropriate treatment of pediatric vascular anomalies.
Observation:
- An infant presented with multiple cutaneous vascular lesions.
- Initial diagnosis was congenital disseminated pyogenic granuloma via histopathology.
- A significant lesion on the left upper eyelid impacted vision.
Findings:
- The infant was ultimately diagnosed with multifocal infantile hemangioma.
- Extracutaneous involvement of the liver was identified.
- The eyelid lesion did not respond to medical therapy.
Implications:
- This case highlights the importance of considering infantile hemangioma in infants with multiple vascular lesions.
- Early diagnosis and management are critical to prevent complications like amblyopia.
- Multidisciplinary approaches may be required for complex cases involving extracutaneous sites.
Abstract:
Cutaneous vascular lesions in the pediatric population are rare and may represent a variety of localized and systemic diagnoses with diverse treatment protocols. We present a unique case of an infant with multiple cutaneous vascular lesions, initially diagnosed as congenital disseminated pyogenic granuloma based on histopathologic findings and later diagnosed as multifocal infantile hemangioma with extracutaneous hepatic involvement. The largest vascular lesion in our patient was on the left upper eyelid, which failed medical treatment and ultimately required surgical excision to prevent amblyopia progression.
