Lymphangioma Presenting as Sudden Proptosis in a Toddler
Rajagopal Arvinth
Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia and Department of Ophthalmology, Hospital Ampang, Selangor, Malaysia.
Visvaraja Subrayan
Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Mimiwati Zahari
Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Prepagaren Narayanan
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Sagili Chandrasekhara Reddy *
Department of Ophthalmology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Orbital lymphangioma commonly occurs in the first decade of life. It is usually congenital, slow growing and can lead to orbital haemorrhage, ptosis, orbital cellulitis, proptosis and compressive optic neuropathy. A 14-months-old male child was brought to the eye clinic with sudden protrusion of the left eye for the past two days. On examination of left eye, a non-axial, non-pulsatile proptosis with ptosis and inferior eyelid ecchymosis were noted. Anterior segment and fundus were normal. Pupil was normal and reacted briskly to light. Intraocular pressure measured with Tonopen was 16 mm Hg. Right eye: anterior segment, fundus, and intraocular pressure were normal. Magnetic resonance imaging of orbits and brain showed left sided multicystic intraconal mass with area of haemorrhage. The diagnosis of left orbital lymphangioma was made. The initial treatment with Propranolol syrup did not reduce the proptosis. Left nasal endoscopic aspiration of blood and orbital decompression was done by the otolaryngologist. The child was followed up for one year and the proptosis was found to be reduced markedly on the left side. Although various modalities of treatment are available for this condition, unfortunately there are no definitive curative treatments currently. In view of its rarity, this case is reported.
Keywords: Proptosis, orbital lymphangioma, orbital decompression, sclerotherapy