Periocular Hemangioma: Clinicopathological Aspects

Abstract

Hemangiomas are pathologically considered to be developmental hamartomatous lesions. In the periocular region, capillary hemangioma is commonly encountered in infants and children, and it is of particular importance because of its critical location if involving the eyelid with obstruction of the visual axis. In this chapter, we aim to briefly discuss the pathogenesis and etiology of such lesions, describe the histopathological features, and the diagnostic immunohistochemical stains used, with differentiating features between infantile hemangioma and capillary hemangioma in adults. In the periocular region, the clinical appearance and manifestations depend on three primary locations of the hemangioma: the superficial, subcutaneous, and deep orbital hemangiomas. Treatment options are similar to hemangioma elsewhere, however, as mentioned above, early treatment may be advocated to avoid developing amblyopia (lazy eye) because of visual deprivation or obstruction. The most used therapy in the periocular region is beta-blockers, either orally or locally. Intralesional steroids and sclerosing agents may also be used. Surgical intervention is reserved for deep orbital-selected lesions.