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Vol. 18. Issue 4.
Pages 320-325 (January 2007)
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Vol. 18. Issue 4.
Pages 320-325 (January 2007)
Hemangioma intraóseo primario de la órbita: a propósito de dos casos
Primary intraosseous hemangioma of the orbit: Report of two cases
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E. Torres-Carranza, A. García-Perla, P. Infante-Cossío
, M. Acosta-Feria, R. Belmonte-Caro, J.L. Gutiérrez-Pérez
Servicio de Cirugía Oral y Maxilofacial. Hospital Universitario Virgen del Rocío. Sevilla
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Resumen

El hemangioma intraóseo primario, aunque rara vez afecta a los huesos de la órbita, se debe tener en cuenta en el diagnóstico diferencial en aquellos pacientes que presenten una masa fija en la órbita o signos de proptosis progresiva no dolorosa. Para el planteamiento terapéutico es crítico valorar la localización exacta y la extensión de la lesión mediante TC y RNM, y establecer si tiene un origen vascular, pues un manejo inadecuado puede dar lugar a una hemorragia severa. El tratamiento quirúrgico se indica ante una proptosis progresiva o una deformidad estética. Se presentan dos casos de pacientes con hemangiomas primarios intraóseos del reborde supralateral de la órbita. Se realizó una extirpación con un margen óseo sano y se reconstruyó la órbita de forma inmediata mediante injertos de calota fijados con placas reabsorbibles. En el seguimiento a 3 años no ha habido evidencia de recurrencia local, y los resultados funcionales y estéticos obtenidos han sido muy satisfactorios.

Palabras clave:
Órbita
Hemangiomas
Intraóseo
Tumor
Incisión bicoronal
Injerto óseo
Placa reabsorbible
Summary

Primary intraosseous hemangioma, though rarely affect the bones of the orbit, should be considered in the differential diagnosis when a patient presents an enlarging mass fixed to the bone in the orbit or signs of progressive painless proptosis. Assessing the exact site and extent of the hemangioma by means of a CT scan and MRI and establishing the vascular origin of the lesion, is critical in the therapeutical planning, since an inadequate management may result in a severe hemorrhage. Progressive proptosis and contour deformity require surgical treatment. Two cases of patients with primary intraosseus hemangioma of the supra-lateral orbital rim are reported. A bony healthy margin excision was performed, followed by immediate reconstruction of the orbit with calvarial bone grafts fixed with resorbable plates. After three-year follow-up there have not been evidence of local recurrence, and the functional and aesthetic results obtained have been very satisfactory.

Key words:
Orbit
Hemangiomas
Intraosseous
Tumour
Bicoronal incision
Bone graft
Resorbable plate

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