Most conjunctival vascular tumors are benign

With the exception of pyogenic granuloma and Kaposi's sarcoma, there have been no large series reflecting the experience of one group with conjunctival vascular tumors. This retrospective review published in the September issue of Ophthalmology reports on 140 patients treated at the Ocular Oncology Service at Wills Eye Institute. It found that a variety of vascular tumors can occur in both children and adults at various anatomic locations in the conjunctiva. They tend to occur unilaterally on the bulbar conjunctiva, and the majority of tumors are benign.

Among the 140 eyes with vascular tumors and related lesions of the conjunctiva, the specific diagnoses included lymphangioma/lymphangiectasis (39 percent), pyogenic granuloma (22 percent), capillary hemangioma (14 percent), Kaposi's sarcoma (7 percent), acquired sessile hemangioma (7 percent), racemose hemangioma (5 percent), varix (3 percent), cavernous hemangioma (2 percent) and glomangioma (1 percent).

Ninety-three percent of the tumors were benign. The lesions were unilateral in 89 percent of cases and discovered at a median age of 41 years. Bilateral lesions included lymphangiectasia, Kaposi's sarcoma and racemose hemangioma. All tumors were typically found in adults, with the exception of capillary hemangioma and glomangioma.

The median tumor diameter was 6 mm, with the largest median diameter (15 mm) with Kaposi's sarcoma and (12 mm) glomangioma and capillary hemangioma, and the smallest median diameter (3 mm) with cavernous hemangioma. The most common anatomic sites included bulbar conjunctiva, which was extralimbal in 80 patients (57 percent), limbal in 19 patients (14 percent), tarsal conjunctiva in 27 patients (19 percent) and forniceal conjunctival in 24 patients (17 percent). Clinical features included cystic component in 24 percent of patients (seen with lymphangioma, glomangioma and varix), well-defined margins in 64 percent and feeder vessels in 39 percent.