Capillary Hemangioma

Definition

Capillary hemangiomas are one of the main common benign orbital tumors suffered by children. Histopathologically, these lesions are densely cellular and consist of numerous small, blood-filled channels lined by plump endothelial cells with associated pericytes and little contribution from larger vessels or stroma.

A capillary hemangioma is nothing but a bright red birthmark that can sometimes be the most noticeable feature of a little baby. They are benign endothelial cell neoplasms that often don't appear until a baby is a month old but characteristically have rapid growth during infancy and give spontaneous involution later in life. This is in contrast to another known group of childhood vascular anomalies, vascular malformations.

Causes of Capillary Hemangioma

1. These are similar to strawberry hemangioma but situated deep in the skin.
2. The cause is unknown. They are usually not present on birth time but later developed after birth.
3. The color results from the extensive development of blood vessels at the site. The more blood in vessels, redder is the skin. Normal skin goes pale when we are cold i.e. blood vessels constrict and goes bright red when we blush i.e. blood vessels dilate.

Symptoms of Capillary Hemangioma

1. Patients can have severe symptoms like seizures, headaches, paralysis, bleeding in the brain and even death. The nature and severity of the symptoms depend on the lesion's location in the brain.
2. In capillary hemangioma there develop skin markings before or shortly after birth.
3. Skin rash or lesion that is red
4. There may be skin markings that look like blood vessels.

Treatment of Capillary Hemangioma

Capillary hemangioma in children is a self-limiting problem, and conservative treatment is recommended. These birthmarks can be associated with a great deal of morbidity. There is definitely a role for a palliative form of treatment without systemic complications or destruction of adjacent tissue.

Management of Stawberry Nevus depends on ocular complications, such as the development of amblyopia (lazy eye) or strabismus. Active treatment to reduce the size of the lesion is indicated only if there is occlusion of the visual axis or if a posterior lesion results in progressive proptosis with evidence of optic nerve compression, corneal exposure and significant and progressive amblyopia brought about by obscuration of vision or astigmatism.

Most orbital capillary hemangiomas which cause secondary ocular complications may be treated with either systemic or intralesional (injected into the tumor) steroids. The prognosis is generally good. The list of choices for treatment is not long.