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Venous-lymphatic Malformations (Lymphangioma) of the Orbit: Diagnostic and Therapeutic Challenges

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Oculoplastics and Orbit

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

Vascular anomalies of the orbit include venouslymphatic malformations (VLM). These lesions, often referred to as lymphangioma, are considered congenital and most commonly present in childhood. Approximately one-third are identified in the first weeks of life [17]. VLM represented 4% of 1,264 orbital tumors in Shields’ series [35] and 3% of 600 in Iliff and Green’s series [20]. The most common presenting sign is painful unilateral proptosis resulting from spontaneous hemorrhage (Fig. 7.1a). Less commonly, VLM may enlarge slowly (Fig. 7.2a, b).

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References

  1. Al-Adnani M, Williams S, Rampling D, et al. (2006) Histopathological reporting of paediatric cutaneous vascular anomalies in relation to proposed multidisciplinary classification system. J Clin Pathol 59:1278–1282

    Article  PubMed  CAS  Google Scholar 

  2. Banieghbal B, Davies MR (2003) Guidelines for the successful treatment of lymphangioma with OK-432. Eur J Pediatr Surg 13:103–107

    Article  PubMed  CAS  Google Scholar 

  3. Baskin D, Tander B, Bankaoglu M (2005) Local bleomycin injection in the treatment of lymphangioma. Eur J Pediatr Surg 15:383–386

    Article  PubMed  CAS  Google Scholar 

  4. Berenguer B, Mulliken JB, Enjolras O, et al. (2003) Rapidly involuting congenital hemangioma: clinical and histopathologic features. Pediatr Dev Pathol 6:495–510

    Article  PubMed  Google Scholar 

  5. Bilaniuk LT (1999) Orbital vascular lesions: role of imaging. Radiol Clin North Am 37:169–183

    Article  PubMed  CAS  Google Scholar 

  6. Bilaniuk LT (2002) Imaging the pediatric orbit. In: Katowitz JA (ed) Pediatric oculoplastic surgery. Springer, New York, pp 365–405

    Google Scholar 

  7. Boulos PR, Harissi-Dagher M, Codere F, et al. (2005) Intralesional injection of Tisseel fibrin glue for resection of lymphangioma and other thin-walled orbital cysts. Ophthal Plast Reconstr Surg 21:171–176

    Article  PubMed  Google Scholar 

  8. DePuey EG, Richards WO, Millikan WJ, et al. (1988) Scintigraphic detection of pulmonary embolization of esophageal variceal sclerosant. Endoscopy 20:91–94

    Article  PubMed  CAS  Google Scholar 

  9. Emran MA, Dubois J, Laberge L, et al. (2006) Alcoholic solution of zein (Ethibloc) sclerotherapy for treatment of lymphangiomas in children. J Pediatr Surg 41:975–979

    Article  PubMed  Google Scholar 

  10. Enjolras O (1997) Classification and management of the various superficial vascular anomalies: hemangiomas and vascular malformations. J Dermatol 24:701–710

    PubMed  CAS  Google Scholar 

  11. Ernemann U, Westendorff C, Troitzsch D, et al. (2004) Navigation-assisted sclerotherapy of orbital venolymphatic malformation: a new guidance technique for percutaneous treatment of low-flow vascular malformations. Am J Neuroradiol 25:1792–1795

    PubMed  Google Scholar 

  12. Frisbie JH (2005) An animal model for venous thrombosis and spontaneous pulmonary embolism. Spinal Cord 43:635–639

    Article  PubMed  CAS  Google Scholar 

  13. Galambos C, Nodit L (2005) Identification of lymphatic endothelium in pediatric vascular tumors and malformations. Pediatr Dev Pathol 8:181–189

    Article  PubMed  Google Scholar 

  14. Greene AK, Burrows PE, Mulliken JB, et al. (2005) Periorbital lymphatic malformation: clinical course and management in 42 patients. Plast Reconstr Surg 115:22–30

    Article  PubMed  CAS  Google Scholar 

  15. Gunduz K, Demirel S, Yagmurlu B, et al. (2006) Correlation of surgical outcome with neuroimaging findings in periocular lymphangiomas. Ophthalmology 113:1236

    Google Scholar 

  16. Harris GJ (1999) Orbital vascular malformations: a consensus statement on terminology and its clinical implications. Am J Ophthalmol 127:453–455

    Article  PubMed  CAS  Google Scholar 

  17. Harris GJ, Sakol PJ, Bonavolonta G, et al. (1990) An analysis of thirty cases of orbital lymphangioma. Pathphysiologic considerations and management recommendations. Ophthalmology 97:1583–1592

    PubMed  CAS  Google Scholar 

  18. Hasegawa M, Fulisawa H, Hayshi Y, et al. (2005) CT arteriography for orbital tumors: diagnostic and surgical value. J Clin Neurosci 12:548–552

    Article  PubMed  Google Scholar 

  19. Hsuan J, Malhotra R, Davis G, et al. (2004) Orbital decompression for gross proptosis associated with orbital lymphangioma. Ophthal Plast Reconstr Surg 20:463–465

    Article  PubMed  Google Scholar 

  20. Iliff WJ, Green WR (1979) Orbital lymphangiomas. Ophthalmology 86:914–929

    PubMed  CAS  Google Scholar 

  21. Jordan DR, Anderson RL (1987) Carbon dioxide (CO2) laser for conjunctival lymphangioma. Ophthalmic Surg 18:728–730

    PubMed  CAS  Google Scholar 

  22. Katz SE, Rootman J, Vangveeravong S, et al. (1998) Combined venous lymphatic malformations of the orbit (so-called lymphangiomas). Association with noncontiguous intracranial vascular anomalies. Ophthalmology 105:176–184

    Article  PubMed  CAS  Google Scholar 

  23. Kazim M, Kennerdell JS, et al. (1992) Orbital lymphangioma. Correlation of magnetic resonance images and intraoperative findings. Ophthalmology 99:1588–1594

    PubMed  CAS  Google Scholar 

  24. Kennerdell JS, Maroon JC, Garrity JA, et al. (1986) Surgical management of orbital lymphangioma with the carbon dioxide laser. Am J Ophthalmol 102:308–314

    PubMed  CAS  Google Scholar 

  25. Lewin JS (2004) Low-flow vascular malformations of the orbit: a new approach to a therapeutic dilemma. Am J Neuroradiol AJNR 25:1633–1634

    Google Scholar 

  26. Luzzatto C, Lo Piccolo R, Fascetti LF, et al. (2005) Further experience with OK-432 for lymphangiomas. Pediatr Surg Int 21:969–972

    Article  PubMed  CAS  Google Scholar 

  27. Lyons C, Rootman (2005) Vascular disease. In: Taylor D, Hoyt C (eds) Pediatric ophthalmology and strabismus. Elsevier, New York, pp 385–396

    Google Scholar 

  28. Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422

    PubMed  CAS  Google Scholar 

  29. Ogita S, Tsuto T, Takahasi T (1987) A case report of sclerosing therapy with OK-432 for cystic hygroma in children. Geka (Surgery) 49:421–423

    Google Scholar 

  30. Ogita S, Tsuto T, Nakamura K, et al. (1993) OK-432 therapy for cystic hygroma and cavernous lymphangioma. Jpn J Pediatr Surg 25:371–376

    Google Scholar 

  31. Rootman J (2003) Vascular malformations of the orbit: hemodynamic concepts. Orbit 22:103–120

    Article  PubMed  Google Scholar 

  32. Rootman J, Hay E, Graeb D, et al. (1986) Orbital-adnexal lymphangiomas. A spectrum of hemodynamically isolated vascular hamartomas. Ophthalmology 93:1558–1570

    PubMed  CAS  Google Scholar 

  33. Ryoma Y, Moriya Y, Okamoto M, et al. (2004) Biological effect of OK-432 (picibanil) and possible application to dendritic cell therapy. Anticancer Res 24:3295–3301

    PubMed  CAS  Google Scholar 

  34. Schwarcz RM, Ben Simon GJ, Cook T, et al. (2006) Sclerosing therapy as first line treatment for low flow vascular lesions of the orbit. Am J Ophthalmol 141:333–339

    Article  PubMed  Google Scholar 

  35. Shields JA, Shields CL, Scartozzi S (2004) Survey of 1264 patients with orbital tumors and simulating lesions; the 2002 Montgomery lecture, part 1. Ophthalmology 111:997–1008

    Article  PubMed  Google Scholar 

  36. Selva D, Strianese D, Rootman J, et al. (2001) Orbital venous-lymphatic malformations (lymphangiomas) mimicking cavernous hemangiomas. Am J Ophthalmol 131:364–370

    Article  PubMed  CAS  Google Scholar 

  37. Sidle DM, Maddalozzo J, Meier JD, et al. (2005) Altered pigment epithelium-derived factor and vascular endothelial growth factor levels in lymphangioma pathogenesis and clinical recurrence. Arch Otolaryngol Head Neck Surg 131:990–995

    Article  PubMed  Google Scholar 

  38. Siniluoto TM, Svendsen PA, Wikholm GM, et al. (1997) Percutaneous sclerotherapy of venous malformations of the head and neck using sodium tetradecyl sulphate (sotradecol). Scand J Plast Reconstr Surg Hand Surg 31:145–150

    Article  PubMed  CAS  Google Scholar 

  39. Sires BS, Goins CR, Anderson RL, et al. (2001) Systemic corticosteroid use in orbital lymphangioma. Ophthal Plast Reconstr Surg 17:85–90

    Article  PubMed  CAS  Google Scholar 

  40. Stroncek DF, Hutton SW, Silvis SE, et al. (1985) Sodium morrhuate stimulates granulocytes and damages erythrocytes and endothelial cells: probable mechanism of an adverse reaction during sclerotherapy. J Lab Clin Med 106:498–504

    PubMed  CAS  Google Scholar 

  41. Suzuki Y, Obana A, Gohto Y, et al. (2000) Management of orbital lymphangioma using intralesional injection of OK-432. Br J Ophthalmol 84:614–617

    Article  PubMed  CAS  Google Scholar 

  42. Tawfik HA, Budin H, Dutton JJ (2005) Lack of response to systemic corticosteroids in patients with lymphangioma. Ophthal Plast Reconstr Surg 21:302–305

    Article  PubMed  Google Scholar 

  43. Tunç M, Sadri E, Char DH (1999) Orbital lymphangioma: an analysis of 26 patients. Br J Ophthalmol 83:76–80

    PubMed  Google Scholar 

  44. Vilanova JC, Barcelò J, Villalòn M (2004) MR and MR angiography characterization of soft tissue vascular malformations. Curr Probl Diagn Radiol 33:161–170

    Article  PubMed  Google Scholar 

  45. Wesley RE, Bond JB (1985) Carbon dioxide laser in ophthalmic plastic and orbital surgery. Ophthalmic Surg 16:631–633

    PubMed  CAS  Google Scholar 

  46. Won JH, Kim BM, Kim CH, et al. (2004) Percutaneous sclerotherapy of lymphangiomas with acetic acid. J Vasc Interv Radiol 15:595–600

    PubMed  Google Scholar 

  47. Wojno T (1999) Sotradecol (sodium tetradecyl sulfate) injection of orbital lymphangioma. Ophthal Plast Reconstr Surg 15:432–437

    Article  PubMed  CAS  Google Scholar 

  48. Wright JE, Sullivan TJ, Garner A, et al. (1997) Orbital venous anomalies. Ophthalmology 104:905–913

    PubMed  CAS  Google Scholar 

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Rudolf Guthoff James Katowitz

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(2007). Venous-lymphatic Malformations (Lymphangioma) of the Orbit: Diagnostic and Therapeutic Challenges. In: Guthoff, R., Katowitz, J. (eds) Oculoplastics and Orbit. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33677-8_7

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  • DOI: https://doi.org/10.1007/978-3-540-33677-8_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33675-4

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