Open AccessLow-dose propranolol for the treatment of deep infantile hemangioma with orbital involvement
Author(s) -
Shu-Ya Wu,
ChienCheng Chen,
Ming-Chou Chiang,
Yueh-Ju Tsai
Publication year - 2014
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.519
H-Index - 9
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.1016/j.tjo.2013.12.004
Subject(s) - medicine , propranolol , capillary hemangioma , hemangioma , magnetic resonance imaging , eyelid , orbit (dynamics) , surgery , radiology , anesthesia , engineering , aerospace engineering
Capillary hemangiomas are the second most common childhood tumor of the orbit and may cause proptosis and amblyopia if untreated. Oral propranolol has recently been reported to be an effective and safe alternative. Herein, we describe a 2-month-old boy presented with a deep capillary hemangioma of his left eye. It continued to enlarge rapidly and magnetic resonance imaging of the orbit demonstrated hemangioma infiltration over the left superonasal orbit. The patient was treated with oral propranolol starting at 0.5 mg/kg/day with an incremental increase of 0.5 mg/kg/day every 2 days, up to a maximum of 1.5 mg/kg/day. The patient continued 1.5 mg/kg/day of oral propranolol for 5 months as an outpatient without any complications. The volume of the hemangioma has decreased on the following magnetic resonance imaging and the swollen eyelid dramatically improved after treatment. Oral propranolol at 1.5 mg/kg/day may reduce the volume of deep infantile hemangioma in the proliferative stage. Relatively long duration and slow tapering are recommended to prevent relapse