title: A Critical Analysis of Eleven Periocular Lobular Capillary Hemangiomas in Adults.
abstract: OBJECTIVE
  To provide a critical analysis of a series of periocular lobular capillary hemangiomas in adults, outlining characteristic clinical and histopathologic patterns in comparison with those of other vascular tumors of adults and children.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Review of clinical data, hematoxylin-eosin-stained sections, and immunohistochemical studies of smooth muscle actin (SMA), D2-40, CD34, and glucose transporter 1 (GLUT-1).
  
  
  RESULTS
  The 7 female and 4 male patients were diagnosed with periocular lobular capillary hemangioma at a median age of 39 years (range, 17-82 years). The tumors were small (3-14 mm, median size 6 mm) and well circumscribed, arose over the course of weeks to months, and developed most commonly in the canthal region, followed by the upper eyelid skin. The tumors were all composed microscopically of repeating units of various sizes (lobules) consisting of CD34-postive, GLUT-1-negative endothelial cells and SMA-positive pericytes arranged in macro- or microlobules. Some foci also exhibited ectatic vessels or diffuse, nonlobular capillary proliferations. Excision was curative without recurrence.
  
  
  CONCLUSIONS
  Although capillary hemangiomas are more common in children, lobular capillary hemangiomas can also arise in the periocular region of adults. Some histopathologic features of these lesions are shared with those of infantile hemangioma and tufted angioma of children, but features of the clinical presentation and the results of immunohistochemical staining patterns are distinctive.
authors.affiliation: David G. Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye & Ear Infirmary; and the Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Stagner
authors.affiliation: David G. Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye & Ear Infirmary; and the Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. Electronic address: Fred_Jakobiec@meei.harvard.edu.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
mesh_terms: D000199:Actins / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D005141:Eyelid Diseases / Q000378:metabolism / Q000473:pathology*; D005260:Female; D051272:Glucose Transporter Type 1 / Q000378:metabolism; D017789:Granuloma, Pyogenic / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012871:Skin Diseases / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; D015415:Biomarkers; D051272:Glucose Transporter Type 1; C500987:monoclonal antibody D2-40