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A 7-week-old infant with right upper eyelid mass
Digital Journal of Ophthalmology 2010
Volume 16, Number 4
October 2, 2010
DOI: 10.5693/djo.03.2010.09.001
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John Davis | University of Texas Medical Branch at Galveston
Kapil Kapoor | University of Texas Medical Branch at Galveston
Differential Diagnosis
The differential diagnosis in this case should include all of the following: hematoma, capillary hemangioma, lymphangioma, arteriovenous malformation, port-wine stain, and neuroblastoma. A hematoma may have formed due to the previous week’s ROP examination. Lid speculum placement can be traumatic in newborn babies, and a good assistant is essential to prevent unnecessary movement. Capillary hemangiomas are vascular lesions that may present shortly after birth with progressive enlargement and are more common in females and with premature birth.(1,2) Lymphangiomas present in the first decade of life and often present abruptly as a localized progressive vascular lesion with spontaneous hemorrhage.(3) Arteriovenous malformations consist of anomalous anastamoses between arteries and veins, are typically congenital, and may present with a localized hemorrhage.(4) Port-wine stains (nevus flammeus) consist of deep, dilated capillaries that are often present at birth, frequently affect one side of the face, and can deepen in color as a child ages.(5) Neuroblastoma is the most common extracranial cancer in children and metastatic neuroblastoma can present in young children with sudden and rapidly progressive eyelid ecchymosis that may be unilateral or bilateral.(6)
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