conservative treatment of cavernous hemangioma ... - Journal of IMAB

Figure 2: The procedure of intralesionalinjection of corticosteroidThe involution of tumor lesions started at the endof second year and at the end of third year theaesthetic result and regression were significant.(Figure 3)corticosteroids - have been proposed for treatinghemangioma, but the choice of treatment depend on acareful assessment of every case.[4,6,8]Corticosteroid therapy (intralesional application)has been proposed as the most efficient for cutaneoushemangioma, particularly for those involving the eyelids[2,3,5].Reported complications including occlusion of thecentral retinal artery, eyelid necrosis and optic nerveneuropathy are rare.[2]We injected Betamethasone (Celeston) into thecentral and satellite lesions every six months, for aperiod of four years. During this period no side effectswere observed.The therapy was initiated at the age of 3 months.After one year of treatment the size of the tumor wasunchanged, therefore the lesion would not regresswithout therapy.As it is difficult to predict accurately the durationof growth and the rate of spontaneous involution, thetreatment should be initiated as early as possible, andthe infant should be seen frequently.Figure 3: Result after two years of treatmentDISCUSSION:Hemangioma is a benign tumor in infancy. Thehallmark of this lesion is a rapid growth during theneonatal period. Most hemangiomas do not requiretreatment, as these resolve spontaneously. Batta et al.reported that among 121 infants with early hemangioma,about 40% cleared completely or left a minimal residualsign at the age of 1 year without treatment.Nevertheless, some complications or aesthetic concernsare indications for therapy. A number of treatmentmodalities – cryotherapy, radiation, laser therapy,Figure 4: Result after three years of treatmentThis case clearly demonstrates the positive resultsof using intralesional steroids. (Figure 4) Theophthalmic literature shows that local application isgenerally preferred over the oral route for eyelidlesions.[7]In conclusion, the best approach in managementof hemangioma should be individualized according to theage of patient, location, size of the lesion, and presenceof complications. Once the decision to treat hemangioma/ J of IMAB, 2007, vol. 13, book 1 / http://www.journal-imab-bg.org 41