Cavernous Haemangioma of Eyelid is a hamartoma, which arises usually after the second decade of life. Eyelid lesion is less common as compared to orbital tumour. It usually accompanies the orbital tumour and the occurrence of isolated eyelid lesion is rare.
Sinusoidal haemangioma, a subtype of cavernous haemangioma, involves eyelid with aggressive growth pattern. It invades adjacent eyebrow and cheek.
Blue rubber bleb naevus syndrome, a rare entity, is characterised by multiple cutaneous cavernous haemangiomas associated with gastrointestinal haemangiomas which often bleed.
Cavernous haemangioma may present with dark blue, compressible, lobulated lesion which increases slowly in size.
Cavernous haemangioma represents hamartoma.
A hamartoma (developmental tumour) is a tumour like growth and it consists of disorganised group of cells and tissues normally found in the areas of growth in body.
Cavernous haemangioma of the eyelid, a rare acquired condition, is generally seen in adults.
Clinically, superficial lesions are lobulated, compressible, dark blue coloured, and slowly progressive lesions. These lesions may produce amblyopia due to mass effect of ptosis or from astigmatism produced by ocular compression.
Cavernous haemangiomas show endothelium lined, large dilated blood filled spaces. These vascular spaces are separated by fibrous stroma. These tumours are well circumscribed but are not encapsulated. There may be signs of focal chronic inflammation. There is no endothelial proliferation unlike acquired capillary haemangioma of eyelid. There may be thrombosis or foci of calcification.
The differential diagnosis includes
Spontaneous regression of cavernous haemangioma has been reported, but it is more characteristic of capillary haemangioma.
Surgical therapy by local excision may be required for lesions threatening amblyopia.
It may also be requested for cosmetic reasons.
Therapies such as intra-lesional sclerosing agents, cryotherapy, and fractionated doses of brachytherapy have been tried.