A one month old infant presents with a spongy purplish eyelid mass. The most likely diagnosis is
Rhabdomyosarcoma
Capillary hemangioma
Neurofibroma
Metastatic Ewing's sarcoma
Capillary hemangioma is the most common eyelid tumor in children. Capillary hemangioma (strawberry naveus) It presents sholy after bih as a unilateral, raised bright red lesion usually in the upper lid; a deeper lesion appears purplish . frequently associated with ptosis. In majority of cases(75%), lesions resolve by age of 7 years It may be Associated with PHACES SYNDROME The lesion blanches on pressure & may swell on crying. Treatment -propranolol/Intralesional injection of triamcinolone, and vincristine (for resistant cases) - Neurofibroma Lids & orbits are commonly affected in neurofibromatosis type-1 (von Recklinghausen's disease).The tumor is usually of plexiform type resulting in mechanical ptosis & 'S'- shape deformity of upper lid - Rhabdomyosarcoma :presents as rapidly progressive proptosis of sudden onset in a child of 7-8 years . The clinical presentation mimics an acute inflammatory process. - Metastatic Ewing's sarcoma: metastasize M/C to lungs .rarely to eyes
Lacrimal Apparatus and Eyelid Disorders