Intramuscular cavernous venous malformation of extraocular muscles. Fractionated stereotactic radiotherapy as a therapeutic alternative

Intramuscular cavernous malformation in the temporalis muscle: Diagnosis and treatment of a rare tumor in a rare site

In this case report we present a very rare case of intramuscular cavernous hemangioma in the temporalis muscle which was successfully managed with surgical excision with no evidence of recurrence in follow-up.

3D printing personalized guide plate in the management of recurrent intramuscular venous malformations: A single center experience

Objective

This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods

Fifteen patients with recurrent IVM were retrospectively assessed. 3D-slicer software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results

Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion

The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.

Intracranial extension of an intramuscular haemangioma of superior rectus: case report and literature review

Background

Intramuscular haemangiomas are rare, benign vascular tumours that represent < 1% of all haemangiomas. When involving the extraocular muscles, haemangiomas are extremely rare, with only nine cases reported in the literature; to date there are no reported cases of extraocular muscle haemangiomas extending into the brain.

Case presentation

A 6-year-old boy with a two-week history of a painless swelling and erythema on the upper eyelid. On examination, the patient had restricted extraocular motility in all directions of gaze. In addition, the eye appeared proptotic, with chemosis and hyperaemia of the conjunctiva. Visual acuity and intraocular pressure were normal. Orbital computed tomography imaging showed a mass in the left superior rectus, with heterogeneous enhancement following contrast administration. Incisional biopsy revealed an intramuscular haemangioma of the superior rectus muscle with capillary-type vessels. The patient received an intralesional steroid, which improved the condition for a few months; however, the lesion later recurred and included an intracranial extension.

Conclusion

This case represents the first reported case of intracranial extension of intramuscular haemangioma of extraocular muscle.

Ocular adnexal intramuscular hemangioma arising from the eyelid: case report and literature review

Intramuscular hemangioma (IMH) is rare in the ocular adnexa and is uncommonly found in infants. We describe a 1-month-old female infant with an unremarkable birth history presented with subacute onset of right upper eyelid swelling. Clinical examination revealed a purplish subcutaneous mass over the right upper eyelid causing mechanical ptosis. MRI revealed a well-defined subcutaneous mass, which was hyperintense on the T1 weighted images and showed intense enhancement after administration of intravenous gadolinium. Our working diagnosis was infantile capillary hemangioma, and the patient received two intralesional steroid injections without diminishing the lesion size. The lesion had become static in size and the subsequent MRI 14 years later revealed the same lesion had become hyperintense on the T1 weighted image. An excisional biopsy revealed mixed type IMH. IMH should be considered among young patients with upper eyelid swelling, particularly in those who show a poor response to steroid treatment.