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Orbital primary intraosseous hemangioma in a three-month old infant: A case report
Babak Masoomian1, Hassan Asadigandomani1, Seyed Mohsen Rafizadeh1
1Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
A rare, rapidly growing orbital intraosseous hemangioma in a 3-month-old boy was successfully treated with surgery. This case highlights the importance of considering this diagnosis in infants with aggressive orbital masses.
Area of Science:
- Pediatric Oncology
- Ophthalmology
- Vascular Malformations
Background:
- Orbital tumors in infants can present aggressively, mimicking malignancy.
- Intraosseous hemangiomas are rare vascular tumors that can occur within bone structures.
Observation:
- A 3-month-old boy presented with a rapidly growing, large (5x5cm) right orbital mass.
- Imaging revealed a destructive mass with intracranial extension, posing a diagnostic challenge.
- The mass was initially suspected to be a more ominous malignancy due to its rapid progression and size.
Findings:
- Surgical excision and orbital rim reconstruction were performed.
- Histopathological examination confirmed the diagnosis of intraosseous hemangioma.
- The patient showed no recurrence after a 1-year follow-up period.
Implications:
- This case underscores the need to consider intraosseous hemangioma in the differential diagnosis of rapidly progressing orbital tumors in infants.
- Despite its rarity, prompt diagnosis and surgical management are crucial for favorable outcomes.
- Challenges in infant surgery, including blood loss and intracranial extension, were successfully managed.
Purpose:
To report a 3-month-old boy with rapid progressive orbital intraosseous hemangioma which was treated with excisional biopsy and orbital rim reconstruction.
Observation:
A 3-month-old boy was referred with the aggressive growth of a mass on the right orbital region. The mass was noted to develop over 4 weeks. On presentation this firm nontender orbital mass measuring 5 × 5cm mimicked a more ominous malignancy. The spiral computed tomography scan showed a destructive mass with protrusion superiorly and inferiorly toward the orbital cavity and anterior cranial fossa. The patient underwent gross tumor resection and reconstruction of the orbital rim. Histology findings revealed an intraosseous hemangioma. There was no evidence of recurrence after 1-year follow-up.
Conclusion And Importance:
Due to rapid progression, the patient's age, and lesion size, this case is unique. There were additional challenges regarding complete resection, intra-cranial extension, and significant blood loss in an infant. Therefore, in the face of rapidly progressing orbital tumors in infants, despite the very low prevalence of intraosseous hemangioma, this diagnosis should be considered.
