Transarterial embolization for cervical hemangioma associated with Kasabach-merritt syndrome

A 2-month-old girl presented with cervical hemangioma associated with Kasabach-Merritt syndrome. The patient had previously undergone systemic administration of corticosteroids (prednisolone 2 mg/kg/day) and radiotherapy (0.5 Gy × 5 times), which temporarily increased the platelet count, but the effects were short-lived and thrombocytopenia gradually worsened again despite increased dosage of prednisolone to 5 mg/kg/day. Computed tomography and magnetic resonance imaging revealed a hemangioma in the left retroauricular-cervical region with a well-enhanced, ill-defined margin and bony structure involvement. Diagnostic and therapeutic angiography were carried out through the femoral route under general anesthesia. Polyvinyl alcohol particles (250-350 µm) suspended in contrast medium were slowly injected and a fibered coil was finally placed in the proximal portion of the arterial feeder. Angiography after embolization revealed a marked reduction in the tumor stain. Platelet count rapidly increased and reached the normal range on postembolization day 7. Tumor tension decreased on the day after the procedure and tumor size gradually decreased. The patient was discharged with oral corticosteroid therapy at 6 months postembolization. Corticosteroid dose was gradually decreased and coagulation parameters were normal at 1 year postembolization.