Periocular infantile hemangioma masquerading as dacryocele

Bonafede, Lucas; Go, Michelle S.; Cheng, Jeffrey; Belcastro, Alexandra A.; Bellet, Jane S.; Gabr, Hesham; Freedman, Sharon F.; Velez, Federico G.

doi:10.1016/j.jaapos.2020.07.001

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…14 and Bonafede et al . 15 reported infantile hemangioma misdiagnosed as dacryocystocele. Intraoperatively, the lesions appeared discontinuous with the nasolacrimal system and could not be decompressed.…”

Section: Discussionmentioning

confidence: 99%

“…Isolated case reports on vascular masses in the lacrimal sac area have been published. [12][13][14][15][16][17] In most previous case reports, the lesion was identified preoperatively by their clinical characteristics and on imaging.…”

Section: Inferomedial Vascular Massesmentioning

confidence: 99%

“…Barras et al 13 reported a case of vascular mass with concurrent functional nasolacrimal duct obstruction (NLDO). Hsu et al 14 and Bonafede et al 15 reported infantile hemangioma misdiagnosed as dacryocystocele. Intraoperatively, the lesions appeared discontinuous with the nasolacrimal system and could not be decompressed.…”

Section: Inferomedial Vascular Massesmentioning

confidence: 99%

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Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele

Diab

Ali

Mohammed

2022

European Journal of Ophthalmology

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Purpose Several non-lacrimal lesions can present with lacrimal sac area swelling mimicking a dacryocystocele or mucocele with a possibility of misdiagnosis. This study investigates the clinic-radiologic characteristics of the mimicking conditions compared to true lacrimal sac distension. Design Retrospective, comparative, interventional case series Participants Patients referred by primary care ophthalmologists between January 2015 and October 2021 with a misdiagnosis of dacryocystocele or lacrimal sac mucocele (n = 39) and an age-matched group of proven true lacrimal sac swelling (TLS group, n = 44). Methods Data collected included demographics, presenting features, investigations, management, histopathology, and outcomes. Both groups were statistically compared for several clinical and radiological variables. Results Final diagnoses in the mimicking group were skin/subcutaneous swellings (14/39, 35.9%), vascular malformations (10/39, 25.6%), inferomedial anterior orbital cysts (7/39, 17.9%), sino-orbital masses (5/39, 12.8%). Female gender (<0.001), epiphora (p = 0.001), and discharge (p < 0.001) were significantly more frequent in the TLS group. The mimicking group was more likely to be associated with a longer swelling duration (p < 0.001), a swelling extending beyond the lacrimal sac area (p <0.001), orbital signs (p <0.001), and periorbital abnormality. Non-patent lacrimal irrigation (p < 0.001) was significantly more frequent in the TLS group. On imaging, all swellings in the mimicking group were separate from the lacrimal pathway and 94.9% (37/39) extended beyond the lacrimal sac fossa. Conclusion Various cutaneous, subcutaneous, vascular, inferomedial orbital cystic, and sinonasal pathologies can present with lacrimal sac area swelling and mimic a TLS. A high index of suspicion, a thorough clinical evaluation and proper imaging are essential to avoid a misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Inferomedial Vascular Massesmentioning

confidence: 99%

See 1 more Smart Citation

Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele

Diab

Ali

Mohammed

2022

European Journal of Ophthalmology

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“…IH usually occurs in the first few weeks of life and spreads quickly during childhood [4]. According to the tissue level of growth, IH can be characterized as superficial, deep, or mixed [5]. IH is classified as focal, multifocal, segmental, and so on, depending on the pattern of growth [6].…”

Section: Introductionmentioning

confidence: 99%

FOXF1 Was Identified as a Novel Biomarker of Infantile Hemangioma by Weighted Coexpression Network Analysis and Differential Gene Expression Analysis

Zhang

Wang

2022

Contrast Media & Molecular Imaging

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Background. The most frequent benign tumor in newborns is infantile hemangioma. The majority of infantile hemangiomas has a favorable prognosis and generally fades away on their own. Some people, however, do experience major consequences. Transcriptome alterations in infantile hemangiomas are yet unclear. The use of transcriptome analysis to uncover diagnostic markers for infantile hemangioma has clinical implications. Methods. The dataset GSE127487 for infantile hemangioma was obtained from the GEO database. The gene set most related with infantile hemangioma was investigated using weighted coexpression network analysis. Differential expression analysis was performed to see whether genes were up or downregulated in infantile hemangiomas. The enrichment of gene sets in pathways or functions is determined via enrichment analysis. Hub genes were discovered via protein-protein interaction network analysis. The relationship between hub genes and immune cells was investigated using immunomicroenvironment analysis. Results. Turquoise and Pink modules were revealed to be the most linked with infantile hemangioma in a weighted coexpression network analysis ( p < 0.001). The genes in the two modules were mostly concentrated in actin filament organization, embryonic organ development, reproductive structure development, cell substrate adhesion, extracellular matrix organization, and so on, according to GO enrichment analysis ( p < 0.05). These gene enrichment pathways comprised the PI3K-Akt signaling pathway, human papillomavirus infection, focal adhesion, and hepatitis C pathways, according to KEGG enrichment analyzes ( p < 0.05). Differential expressed gene analysis showed 43 upregulated and 21 downregulated genes in infantile hemangiomas. We found the gene set most associated to infantile hemangioma by intersecting the elevated genes with the genes acquired by WGCNA, with FOXF1 serving as the hub gene. FOXF1 was linked to the degree of monocyte infiltration, according to immunocorrelation analysis ( p < 0.05). B cell memory, dendritic cells resting, macrophage M0, neutrophils, and T cells helper are all negatively connected ( p < 0.05). In the FOXF1 hyperexpression group, GSEA analysis revealed that cholesterol homeostasis and cell cycle-associated pathways G2M checkpoint were primarily activated ( p < 0.05). Conclusion. FOXF1 was found to be a reliable biomarker of infantile hemangiomas in our research of transcriptome changes in infantile hemangiomas.

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