Surgical dissection of capillary hemangiomas. An alternative to intralesional corticosteroids
R. M. Deans, G. J. Harris and J. D. Kivlin
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee 53226.
Intralesional corticosteroids are often successful in reducing the size of
functionally significant capillary hemangiomas. While they may have a
better benefit-risk ratio than some earlier treatment methods, a number of
serious complications have been reported recently. We believe these
resulted from the hemodynamic continuity of capillary hemangiomas with the
orbital and systemic circulation and that intralesional injections are
intravascular. Surgery has generally been avoided because capillary
hemangiomas are not encapsulated and piecemeal resection can produce
significant bleeding. In carefully selected patients, we have used a
surgical approach that involves dissection on the tumor's surface without
entering its substance. Hemangiomas were removed en bloc from five patients
with insignificant blood loss and excellent anatomic restoration.
