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Capillary Hemangioma (Stawberry Nevus)

Capillary hemangiomas are one of the most 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.

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 (crooked eyes). 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.

It is very important that an accurate diagnosis is reached to plan treatment for this self-limiting condition.  This will certainly help in reassuring anxious parents of children with cosmetically obvious lesions that no active treatment is necessary initially.

Lobular Capillary Hemangioma

Lobular capillary hemangioma is a benign lesion that may occur either on skin or mucosal surfaces, the latter accounting for about 60% of all cases. Lobular capillary hemangioma is a polypoid form of capillary hemangioma occurring on the skin and mucosal surfaces. While lobular capillary hemangioma of the oral and nasal cavity is a well-known entity, tracheal localization is extremely rare.

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Lobular Capillary Hemangioma