CASE REPORT
A RARE CASE OF CAVERNOUS HEMANGIOMA OF THE CONJUNCTIVA
S. Pandu1, Muthukumaran R. S2, Sujatha V3, Srinivas B4, Sharath R. Yajaman5
HOW TO CITE THIS ARTICLE:
S. Pandu, Muthukumaran R. S, Sujatha V, Srinivas B, Sharath R. Yajaman. ”A Rare Case of Cavernous
Hemangioma of the Conjunctiva”. Journal of Evidence based Medicine and Healthcare; Volume 2, Issue 21,
May 25, 2015; Page: 3221-3223.
ABSTRACT: Cavernous hemangioma of the conjunctiva is a rare benign tumour and has been
reported previously only in a few cases, In this report, a 23 year-old male presented with
vascularized swelling in the right eye since 3 months, it was soft, smooth surfaced lesion seen in
the medial canthus of conjunctiva involving conjunctival vessels, he had recurrent episodes since
two years, It was not reducible, not pulsatile and no proptosis. Not associated with any
syndromes and no orbital extension of the lesion. Excisional biopsy was performed, and
histopathological examination confirmed the diagnosis of cavernous hemangioma of conjunctiva.
After removal of the swelling, no recurrence or post-operative complication during the follow-up
period.
KEYWORDS: Cavernous hemangioma, Conjunctiva, Excisional Biopsy.
INTRODUCTION: A haemangioma is a developmental malformation of blood vessels, It may be
capillary, venous (cavernous) or arterial. Its incidence is reported as 1-2% of all benign growths
of the conjunctiva.1 It is considered to be congenital and can also develop over a period of
lifetime. Cavernous hemangioma, also called cavernous angioma, or cavernoma is a benign,
vascular tumour formed by collection of dilated blood vessels, It is uncommon, more so in the
conjunctiva.2 Because of this rarity an interesting clinical report of this condition is reported.
CASE DESCRIPTION: A 23 year-old male presented with red-coloured mass in the right eye
since 3 months [Fig. 1], small in size to begin with, He had recurrent episodes in the past, last
two years he had developed the same condition 3 times which resolved on its own within one
month period of time without any treatment. Except for the cosmetic appearance he had no other
symptoms.
On examination it was vascular, soft, smooth surfaced lesion seen in the medial bulbar
conjunctiva involving the conjunctival vessels, No history of trauma, pain.
Routine blood examinations were normal, CT-Brain, B-Scan Ultrasound were normal.
Excisional biopsy was done and specimen was sent for histopathological examination and
a diagnosis of Cavernous Haemangiorna of conjunctiva was concluded [Fig. 2]. Since then the
patient has been followed up [Fig. 3] with no recurrence and no complication so far and his
cosmetic appearance is normal.
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CASE REPORT
Fig. 1: Red-Coloured mass over the right medial conjunctiva.
Fig. 2: Histopathology- shows multiple spaces lined by flattened epithelium and filled with RBC’s
suggestive of Cavernous hemangioma (hematoxylin-eosin, magnification 100)
Fig. 2
Fig. 1
Fig. 3: After surgical excision post-operative day-1.
Fig. 3
DISCUSSION: Cavernous hemangioma of the conjunctiva are rare and appears as a red or blue
lesion usually in the deep stroma in young children.3 Cavernous hemangioma in the eye are
commonly seen as benign intraorbital tumor in adults, conjuncatival cavernous hemangioma is a
rare presentation in young adults.
It arises often from the conjunctival vessels and rarely from the scleral, muscular or
orbital vessels. It is asymptomatic and stationary for many years. It gives poor cosmetic
appearance and bleeds sometimes giving rise to bloody tears.4,5 The tumour is radiosensitive but
can be treated well by excision.6
CONCLUSION: Common types of vascular tumours in the conjunctiva are pyogenic granuloma,
capillary hemangioma, kaposi sarcoma, lymphangioma.7
This case was asymptomatic except for the cosmetic factor.
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CASE REPORT
Total excision was possible and histopathological examination confirmed the diagnosis, on
follow up till date there is no recurrence (6 months).
The purpose to report this case is to describe a young patient with cavernous
hemangioma of conjunctiva is a very rare entity.
REFERENCES:
1. Hossein Aghaei, MD, Kourosh Shahraki, MD. Isolated Cavernous Hemangioma of the
Conjunctiva: Case Report and Review of Literature. Iranian Journal of Ophthalmology 2013;
25(4): 317-319.
2. Rao MR, Patankar V L, Reddy V. Cavernous haemangioma of conjunctiva (a case report).
Indian J Ophthalmol 1989; 37: 37-8.
3. Yazici B, Ucan G, Adim SB. Cavernous Hemangioma of the conjunctiva: case report. Ophthal
Plast Reconstr Surg 2011; 27(2); e27-8.
4. Kiratli H, Uzun S, Tarlan B, Tanas Ö. Recurrent subconjunctival hemorrhage due to
cavernous hemangioma of the conjunctiva. Can J Ophthalmol 2012; 47(3): 318-20.
5. Malik A, Bhala S, Arya SK, Narang S, Punia RP, Sood S. Isolated cavernous hemangioma of
conjunctiva. Ophthal Plast Reconstr Surg 2010; 26(5): 385-6.
6. Ullman SS, Nelson LB, Shields JA, et al: Cavernous hemangioma of the conjunctiva. Orbit 6:
261, 1988.
7. Hayyam Kiratli, MD Salih Uzun, MD Berçin Tarkan, MD Özlem Tanas, MD Recurrent
subconjunctival hemorrhage due to cavernous hemangioma of the conjunctiva June 2012
47(3):318–320.
AUTHORS:
1. S. Pandu
2. Muthukumaran R. S.
3. Sujatha V.
4. Srinivas B.
5. Sharath R. Yajaman
PARTICULARS OF CONTRIBUTORS:
1. Professor & HOD, Department of
Ophthalmology, M. V. J. Medical College
of Research Institute.
2. Post Graduate, Department of
Ophthalmology, M. V. J. Medical College
of Research Institute.
3. Associate Professor, Department of
Ophthalmology, M. V. J. Medical College
of Research Institute.
4.
5.
Assistant Professor, Department of
Ophthalmology, M. V. J. Medical College
of Research Institute.
Post Graduate, Department of
Ophthalmology, M. V. J. Medical College
of Research Institute.
NAME ADDRESS EMAIL ID OF THE
CORRESPONDING AUTHOR:
Dr. Muthukumaran R. S,
Department of Ophthalmology,
M. V. J. Medical College & Research Institute,
Bangalore-562114.
E-mail: muthukumaranrs@yahoo.in
Date
Date
Date
Date
of
of
of
of
Submission: 22/04/2015.
Peer Review: 23/04/2015.
Acceptance: 07/05/2015.
Publishing: 25/05/2015.
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