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Anupam Jayaram, Gary Lissner; Effect of menopausal status on the progression of orbital cavernous hemangiomas. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5886.
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Cavernous hemangiomas are among the benign neoplasms of the orbit that are often found incidentally and present asymptomatically. It has been shown that orbital cavernous hemangiomas stain positive immunohistochemically for progesterone receptor antibody, suggesting that they are a mesenchymal lesion with possible response to sex steroid (Di Tomassa et al). It has also been described that cavernous hemangiomas of other locations such as the liver and the uterus regress post-menopausally. It can therefore be hypothesized that as circulating levels of estrogen and progresterone decrease in post menopausal women, these lesions in the orbit may also cease progression or possibly even regress. The purpose of this study is to document the likelihood of stabilization or regression of orbital cavernous hemangiomas in post-menopausal women and thus be able to better reassure this patient population and substatiate management by observation.
This study is a retrospective chart review of all patients who had lesions defined as "radiologically consistent with cavernous hemangioma of the orbit" seen through Northwestern Memorial Hospital. All imaging studies were reviewed noting specific dimensions of lesions as well as time interval between studies, and each patient's lesion was defined as progressed, stable, or regressed. Progression and regression were defined as a statistically significant change in size of the lesion. Lesions in men and pre-menopausal women were used as controls to which the lesions in post menopausal women were compared.
A total of 28 patients seen by the oculoplastics department at Northwestern Hospital were identified with imaging studies consistent with cavernous hemangioma of the orbit. Of these patients, the percentage of post menopausal women who demonstrated stable or regressing lesions was greater than the total population of men and women with orbital cavernous hemangiomas who demonstrated stable or regressing lesions.
While cavernous hemangiomas of the orbit frequently remain stable over time, because of their response to hormone levels, these lesions in post-menopausal women seem to remain stable or even regress more often than in men or pre-menopausal women.
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