A 3-year-old boy presented with a vascular lesion involving the left orbit and face. He had a pink macule on his left cheek at birth, which became raised and discolored around age 3 to 4 weeks. He was diagnosed with a capillary hemangioma, and propranolol was started at age 1 month with progression despite dosage increases. Topical timolol was tried without improvement; oral prednisolone decreased the size of the lesion, but was poorly tolerated and discontinued. An ophthalmic evaluation at an outside hospital was concerning for amblyopia because of anisohypermetropia, greater on the left, and a left esotropia and hypertropia. A magnetic resonance image revealed an orbital mass surrounding the left lateral rectus muscle with mass effect on the globe and extension into the eyelid, pterygopalatine fossa, and cheek.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Catherine Y. Liu, MD, PhD, Division of Oculofacial Plastic and Reconstructive Surgery, Shiley Eye Institute, University of California, San Diego, 9415 Campus Point Dr, La Jolla, CA 92093 (email@example.com).
Published Online: July 7, 2022. doi:10.1001/jamaophthalmol.2022.1541
Conflict of Interest Disclosures: Dr Liu reported a research grant from Horizon Therapeutics and royalties from Wolters Kluwer Health outside the submitted work. No other disclosures were reported.
Additional Contributions: We thank the patient’s family for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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