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Management of a Large Periocular Infantile Hemangioma with Oral Propranolol and Surgical Excision: A Case Report and Review

Michelle Y.Y. Wong, Gordon S.K. Yau, Jacky W.Y. Lee, Aaron T. K. Chu, Victor T.Y. Tam and Can Y.F. Yuen

Hemangioma is a common vascular tumor of childhood. Management of large periocular infantile hemangiomas is challenging as it may result in deprivational amblyopia, squint and severe disfigurement. Timely and multidisciplinary management is required when complications arise. The purpose of the study was to report a case of a large periocular capillary hemangioma that was successfully treated with oral propranolol followed by surgical excision. A 2 month old girl presented with a large upper eyelid infantile capillary hemangioma complicated by dense amblyopia. The hemangioma failed to regress despite a course of oral steroid and 3 intra-lesional steroid injections. She was subsequently treated with oral propranolol followed by surgical excision of the hemangioma. At 1 year after treatment, her periocular hemangioma regressed with good cosmetic and visual outcome. Visually threatening periocular infantile hemangioma can be successfully treated with a combination of oral propranolol followed by surgical excision.