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NR. 3/2008
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Diagnostyka
naczyniaka limfatycznego oczodołu u dzieci i jego leczenie
Orbital Lymphangioma Diagnostics and Treatment in Children
Barbara Chipczyńska, Mirosława
Grałek, Wojciech Hautz, Beata Kocyła-Karczmarewicz
Klinika Okulistyki, Instytut „Pomnik – Centrum Zdrowia Dziecka”
w Warszawie
Kierownik: prof. dr hab. n. med. Mirosława Grałek |
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| Summary: |
Orbital lymphangioma is a
vascular malformation described as hamartoma, combined
of venous-lymphatic malformation. It is usually
diagnosed in early childhood. In contrast with the
benign histology, these lesions have a locally
aggressive nature. They are slightly more common in
females than in males, with a gender ratio of 1.35:1.
The purpose of the study is to present the diagnostics
difficulties, clinical course and management of orbital
lymphangioma in children.
Material and Methods: Ten patients with orbital
lymphangioma were observed in The Department of
Ophthalmology of the Children’s Memorial Health
Institute in the period of time from 1995 to 2008. The
clinical findings, imaging diagnostics, biopsy with
histopathological examination and treatment were
described in this study. The case of a 6.5-years-old
girl was described in detail because she demonstrated
the most invasive course of the disease. The child was
hospitalized due to acute onset of painful proptosis,
diplopia, decreased vision, optic disc oedema, and
concomitant nausea.
Results: Six children were diagnosed with benign form of
lymphangioma. Lymphangiomas were localized due to
clinical examination and
CT/ or MRI in upper -nasal quadrant of anterior part of
the orbit. Despite of intermittent disease
intensification the children’s health remained stable
during the observation period. Children were treated
with conservative therapy. Four children with
lymphangioma in the middle and posterior part of the
orbit underwent open biopsy and histopathological
examinations on account of the proliferative disease
suspicion. Three of these children required surgical
treatment (one of them was operated twice).
Conclusions: Lymphangioma diagnosis demands not only
clinical examination but also imaging diagnostics and
occasionally histopathological verification. The
management should be as conservative as possible (bed
rest, systemic corticosteroids). Surgery is
controversial and decision about surgical treatment
requires accurate qualification and adequate surgical
methods. There is a risk of serious complications after
surgery. |
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| Key words: |
lymphangioma, children,
clinical findings, proptosis, imaging diagnostics,
treatment. |
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