Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Ophthalmic Plast Reconstr Surg. 2012 Jul-Aug;28(4):e88-90. doi: 10.1097/IOP.0b013e31823645f9.
An 11-year-old boy presented with progressive right-sided proptosis and an orbital mass on neuroimaging. Incisional biopsy revealed an epithelioid hemangioma. The patient underwent an orbitotomy with subtotal excision of the mass. However, the tumor recurred and progressed to the cavernous sinus, despite oral steroids, tacrolimus, and a second subtotal excision. Because of encouraging results reported with beta-blockers in the treatment of pediatric capillary hemangiomas, the patient was subsequently started on oral propranolol, 2 mg/kg/day, with discontinuation of steroids and tacrolimus. A rapid and impressive interval decrease in tumor size was observed, with improvement in proptosis and exposure keratopathy. The patient remains without recurrence approximately 9 months after initiation of propranolol. Our results suggest that oral propranolol may be a potential alternative therapy when complete excision of an epithelioid hemangioma is not practical.
一名 11 岁男孩出现进行性右侧眼球突出和眼眶内肿块，神经影像学检查发现为上皮样血管内皮瘤。患者接受了眼眶切开术和肿块次全切除术。然而，尽管使用了口服类固醇、他克莫司和第二次次全切除术，肿瘤仍复发并进展至海绵窦。由于β受体阻滞剂在治疗小儿毛细血管血管瘤方面的疗效令人鼓舞，随后患者开始口服普萘洛尔，剂量为 2mg/kg/天，停用了类固醇和他克莫司。观察到肿瘤大小迅速而显著地减小，眼球突出和暴露性角膜炎得到改善。大约在开始服用普萘洛尔 9 个月后，患者未再复发。我们的结果表明，当无法完全切除上皮样血管内皮瘤时，口服普萘洛尔可能是一种潜在的替代治疗方法。
