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This 2-year-old boy has been slowly developing a swelling in his left cheek as shown in the picture above. He is not troubled by tearing (epiphora) and has no recent history of conjunctivitis. The skin of the cheek appears normal but develops a “bluish” tint and the mass becomes slightly larger when he cries or strains. The child is otherwise normal and is in no distress. Vision is normal and refraction is + 0.50 in both eyes.

1.	A likely diagnosis is:
	a. dacryocele b. rhabdomyosarcoma c. exudative sinusitis d. encapsulated hemangioma e. none of the above
2.	Which of the following would be appropriate for this condition?
	a. do nothing; any treatment would make the problem worse b. injection with local anesthetic c. excision of the lesion “in the capsule” through a skin incision d. repeated pressure on the lesion to rupture the lesion e. none of the above
3.	After treatment, you could expect:
	a. recurrence of the lesion in about 50% of cases b. no recurrence if the lesion is removed c. there is no way to tell what to expect d. anisometropic amblyopia e. none of the above

For answers to the above, click here on or after July 7, 2009.