Epithelioid hemangioma of the orbit

Objective: To describe the histopathologic features of two cases of epithel ioid hemangioma occurring in the orbit and to distinguish this condition fr om Kimura's disease and from other vascular lesions of proliferated endothe lium. Design: Two interventional case reports. Intervention: Treatment consisted of orbitotomy with excision of the tumor. Main Outcome Measures: Histopathologic examination including light microsco py, immunohistochemistry, and electron microscopy and clinical follow-up. Results: In one case, there was no local recurrence after 2 years of follow -up, In the other case, local recurrence required re-excision 2 years after surgery with no apparent recurrence 16 years later. Histopathologic examin ation of both tumors disclosed an epithelioid hemangioma. A characteristic finding was the presence of peculiar plump vacuolated endothelial cells lin ing the vascular lumina. Conclusions: Epithelioid hemangioma is an uncommon benign vascular tumor th at can occur in the orbit, and surgical excision is usually required. it is the same condition as angiolymphoid hyperplasia with eosinophilia. There a re distinct clinical and histopathologic characteristics to distinguish epi thelioid hemangioma from Kimura's disease and from other vascular tumors. ( C) 2000 by the American Academy of Ophthalmology.