Trinh Khuu1, Douglas J Hoffman. 1. Dorchester House Multi-Service Center, Dorchester, Massachusetts 02122, USA. Trinh_Khuu@neco.edu
Abstract
BACKGROUND: Choroidal hemangioma is a rare, benign vascular ocular tumor that presents as either a circumscribed mass or as a diffuse variant. Circumscribed choroidal hemangiomas (CCH) resemble posterior segment lesions such as choroidal melanoma, choroidal metastases, central serous chorioretinopathy, or nonspecific retinal detachment. A circumscribed choroidal hemangioma often appears as a subtle red-orange mass or as a grayish lesion in the posterior choroid. In rare instances, CCH may be associated with subretinal fluid accumulation and retinal detachment. CASE REPORT: A 35-year-old Hispanic man presented for a routine eye examination and was observed to have a choroidal lesion in the posterior pole. The lesion is an elevated subretinal mass located superotemporal to the fovea in the right eye. A Humphery visual field 24-2 test found a scotoma corresponding to the location of the lesion. B-scan ultrasound confirmed a fairly dense and large lesion. A-scan showed low to medium internal reflectivity and an acoustically solid lesion. Because the patient was asymptomatic, management through observation was recommended. CONCLUSIONS: Circumscribed choroidal hemangiomas must be adequately differentiated from other vascular tumors. A selective battery of diagnostic tests will facilitate the correct diagnosis. Management of CCH may depend on the character of the lesion and risks of ocular morbidity and vision loss.
BACKGROUND:Choroidal hemangioma is a rare, benign vascular ocular tumor that presents as either a circumscribed mass or as a diffuse variant. Circumscribed choroidal hemangiomas (CCH) resemble posterior segment lesions such as choroidal melanoma, choroidal metastases, central serous chorioretinopathy, or nonspecific retinal detachment. A circumscribed choroidal hemangioma often appears as a subtle red-orange mass or as a grayish lesion in the posterior choroid. In rare instances, CCH may be associated with subretinal fluid accumulation and retinal detachment. CASE REPORT: A 35-year-old Hispanic man presented for a routine eye examination and was observed to have a choroidal lesion in the posterior pole. The lesion is an elevated subretinal mass located superotemporal to the fovea in the right eye. A Humphery visual field 24-2 test found a scotoma corresponding to the location of the lesion. B-scan ultrasound confirmed a fairly dense and large lesion. A-scan showed low to medium internal reflectivity and an acoustically solid lesion. Because the patient was asymptomatic, management through observation was recommended. CONCLUSIONS:Circumscribed choroidal hemangiomas must be adequately differentiated from other vascular tumors. A selective battery of diagnostic tests will facilitate the correct diagnosis. Management of CCH may depend on the character of the lesion and risks of ocular morbidity and vision loss.