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Picture of the Month—Quiz Case
Lisa Weibel, MD;
Susannah Hoey, MBChB, MRCP;
Samira Syed, MBBS, DCH(Lond), DCCH, RCPEd, RCGP, FCM;
John I. Harper, MD, FRCP, FRCPCH;
David Dunaway, FRCS(Plast), FDSRCS;
Yassir Abou-Rayyah, MD
Arch Pediatr Adolesc Med. 2007;161(10):1001.
A 10-week-old infant girl was referred to our hospital with a rapidly growing lesion involving the right orbit. The infant was twin B of nonidentical twins and born prematurely at 29 weeks' gestation. The lesion had been present at birth as a flat purplish mark and had started to increase in size from the age of 10 days. On examination, a large, soft periocular mass was observed and had been completely occluding the right eye from the age of 5 weeks (Figure 1 and Figure 2). The baby was otherwise well. A complete blood cell count and results of coagulation tests and a basic chemistry panel were all normal. Following further diagnostic investigations and therapeutic interventions, the infant required surgical treatment at the age of 17 weeks (Figure 3 and Figure 4).
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Figure 1. Large periocular tumor causing complete occlusion of the right eye.
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Figure 2. Presentation of the tumor in profile.
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Figure 3. Excision of the major bulk of the tumor, measuring 4.5 x 3 x 2 cm.
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Figure 4. Presentation at 10 weeks postsurgery.
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What is your diagnosis?
Author Affiliations: Departments of Pediatric Dermatology (Drs Weibel, Hoey, Syed, and Harper), Pediatric Plastic Surgery (Dr Dunaway), and Pediatric Ophthalmology (Dr Abou-Rayyah), Great Ormond Street Hospital for Children, London, England. Dr Weibel is now with the Dermatology Department, University Hospital Zurich, Zurich, Switzerland.
SECTION EDITORS: SAMIR S. SHAH, MD and ALBERT C. YAN, MD
RELATED ARTICLE
Picture of the Month—Diagnosis
Arch Pediatr Adolesc Med. 2007;161(10):1002.
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