What is Congenital Capillary Haemangioma of Eyelid ?
Congenital Capillary haemangioma of eyelid (strawberry naevus) is a common vascular hamartoma in infants/children and is derived from endothelial rests.
Periorbital haemangioma may present as
- Superficial cutaneous lesion (strawberry haemangioma)
- Subcutaneous lesion
- Deep orbital tumour
- A combination of above mentioned locations.
About one-third of lesions are seen at birth and the remaining lesions are apparent by six months of age.
There is an initial phase of rapid growth followed by a period of dormancy and subsequently spontaneous involution over the years. Majority regresses to some extent by seven to nine years of age. It is more common in girls as compared to boys.
Congenital Capillary Haemangioma of Eyelid Symptoms
Congenital capillary haemangioma may present as
- Flat red coloured lesion with telangiectatic blood vessels
- Enlarged lesions become elevated, red, dome shaped mass with soft consistency
- Subcutaneous lesions present as a bluish-purple mass
- Involuted haemangiomas are pale pink in colour or have white mottled appearance due to fibrosis
Congenital Capillary Haemangioma of Eyelid Causes
Congenital capillary haemangioma, one of the common orbital tumour in children, represents a vascular hamartoma derived from endothelial rests.
About one-third of lesions are seen at birth and the remaining lesions are apparent by six months of age.
Congenital Capillary Haemangioma of Eyelid Diagnosis
Clinically, superficial congenital capillary haemangiomas initially present as a red flat lesion with telangiectatic blood vessels. When enlarged, they become elevated, red, dome shaped mass having soft consistency. The masses are compressible and blanch with pressure.
Subcutaneous lesions present as bluish-purple mass. Like superficial lesions, it is also soft and spongy in consistency. On crying or with Valsalva manoeuvre, haemangiomas enlarge and are darkened in colour as they get filled with blood.
Involuted haemangiomas develop pale pink colour or give white mottled appearance due to fibrosis. These do not blach on pressure.
Histopathology
Congenital capillary haemangiomas are composed of thin walled capillaries. This is lobulated and is separated by septa. The masses are well circumscribed by fibrous tissue. The capillaries may be lined by flattened endothelium and contain erythrocytes.
Investigations
Following investigations may aid in diagnosis
- Computed tomography
- Magnetic resonance imaging
- Ultrasound.
Differential diagnosis
Congenital capillary haemangioma should be differentiated from
- Naevus flammeus
- Lymphangioma
- Cavernous haemangioma
- Encephalocoele
- Rhabdomyosarcoma
- Inflammatory swellings
- Neuroblastoma.
- Dermoid cyst
Congenital Capillary Haemangioma of Eyelid Complications
The most significant ocular complication is amblyopia, which may result due to occlusion of the visual axis or from anisometropia due to pressure induced astigmatism.