Intramuscular hemangiomas of extraocular muscles

Purpose: To report two patients, 3 and 40 years of age, respectively, each of whom had an isolated intramuscular hemangioma of an extraocular muscle. Design: Two retrospective, interventional case reports. Intervention: Incisional biopsy and short-term oral corticosteroids. Main Outcome Measures: Clinical observation and pathologic examination of specimens and tumor status, visual acuity, and ocular motility at final follow-up. Results: Orbital magnetic resonance imaging revealed that, compared with other extraocular muscles, the tumor was isointense on T1-weighted scans and hyperintense on T2-weighted images. Marked homogeneous enhancement was observed after contrast agent administration. Biopsy results showed a hemangioma of the lateral rectus muscle with predominantly capillary-like small vessels in the child and a mixed small and large vessel type hemangioma of the medial rectus muscle in the adult. Conclusions: Intramuscular hemangiomas may cause painless, isolated extraocular muscle enlargement in children and in adults without disturbing the ocular motility. The tumors do not seem to be sensitive to systemic corticosteroid therapy.