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CASE REPORT
Year : 2014  |  Volume : 4  |  Issue : 4  |  Page : 191-193

Low-dose propranolol for the treatment of deep infantile hemangioma with orbital involvement


1 Division of Orbital and Oculoplastic Surgery, Department of Ophthalmology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
2 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
3 Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan

Correspondence Address:
Yueh-Ju Tsai
Division of Orbital and Oculoplastic Surgery, Department of Ophthalmology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan 333
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.tjo.2013.12.004

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Capillary hemangiomas are the second most common childhood tumor of the orbit and may cause proptosis and amblyopia if untreated. Oral propranolol has recently been reported to be an effective and safe alternative. Herein, we describe a 2-month-old boy presented with a deep capillary hemangioma of his left eye. It continued to enlarge rapidly and magnetic resonance imaging of the orbit demonstrated hemangioma infiltration over the left superonasal orbit. The patient was treated with oral propranolol starting at 0.5 mg/kg/day with an incremental increase of 0.5 mg/kg/day every 2 days, up to a maximum of 1.5 mg/kg/day. The patient continued 1.5 mg/kg/day of oral propranolol for 5 months as an outpatient without any complications. The volume of the hemangioma has decreased on the following magnetic resonance imaging and the swollen eyelid dramatically improved after treatment. Oral propranolol at 1.5 mg/kg/day may reduce the volume of deep infantile hemangioma in the proliferative stage. Relatively long duration and slow tapering are recommended to prevent relapse.


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