Capillary Hemangioma Workup

  • Author: Stuart Seiff, MD, FACS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jul 29, 2011
 

Laboratory Studies

  • Immunohistochemical staining is positive for factor VIII.
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Imaging Studies

Neuroimaging studies can be of great assistance in establishing the diagnosis.

Ultrasonography shows a lesion with irregular contour and low-to-medium internal reflectivity.

CT scan reveals a poorly circumscribed mass with no bony erosion. The lesion usually enhances with intravenous contrast.

Magnetic resonance imaging (MRI) reveals a lesion that is hypointense to fat on T1-weighted scans and hyperintense to fat on T2-weighted scans.

A well-circumscribed lobular pattern with prolonged parenchymal staining is seen with angiography. Involuting lesions tend to have less tissue staining.

Cardiac echocardiography and imaging of the great vessels are useful in the diagnosis of PHACES syndrome.

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Histologic Findings

Pathological findings include proliferation of a single layer of endothelial cells and pericytes. Endothelial cells of the basement membrane characteristically have large amounts of endoplasmic reticulum. The small vascular spaces lead to the formation of a high-flow lesion.

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Contributor Information and Disclosures
Author

Stuart Seiff, MD, FACS  Emeritus Professor of Ophthalmology, University of California, San Francisco, School of Medicine; Chief, Department of Ophthalmology, San Francisco General Hospital; Consultant, Oculofacial and Aesthetic Plastic Surgery, California Pacific Medical Center and Mills Peninsula Medical Center

Stuart Seiff, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, and California Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Orin M Zwick, MD  Oculoplastic Surgeon, Chesapeake Eye Care and Laser Center

Orin M Zwick, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association

Disclosure: Nothing to disclose.

Dan D DeAngelis, MD, FRCS(C)  Lecturer, Ophthalmic Plastic and Reconstructive Surgery, Assistant Professor, Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine; Ophthalmologist, Department of Ophthalmology and Vision Sciences, Hospital for Sick Children

Dan D DeAngelis, MD, FRCS(C) is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, California Medical Association, Canadian Medical Association, Canadian Ophthalmological Society, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Susan Carter, MD  Clinical Associate Professor of Ophthalmology, Institute of Ophthalmology and Visual Science, New Jersey Medical School

Susan Carter, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Ophthalmic Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Brian A Phillpotts, MD  Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine

Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.

References

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  18. Al Dhaybi R, Superstein R, Milet A, Powell J, Dubois J, McCuaig C, et al. Treatment of periocular infantile hemangiomas with propranolol: case series of 18 children. Ophthalmology. Jun 2011;118(6):1184-8. [Medline].

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