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Complex hemangiomas of infants and children. Individualized management in 22 cases
T R Weber1, R H Connors, T F Tracy
1Department of Surgery, St Louis University School of Medicine, MO.
Insights
Large hemangiomas in children can be life-threatening but are treatable. A study found that individualized, multi-modal treatment approaches led to successful outcomes with minimal complications in young patients.
Area of Science:
- Pediatric Surgery
- Vascular Anomalies
- Pediatric Oncology
Background:
- Large hemangiomas in children are rare but pose significant risks.
- Potential complications include vital structure involvement, thrombocytopenia, and congestive heart failure.
Purpose of the Study:
- To review the management and outcomes of complex, symptomatic hemangiomas in pediatric patients.
- To highlight the effectiveness of individualized, multi-modal treatment strategies.
Main Methods:
- Retrospective review of 22 pediatric patients treated for complex hemangiomas over a 6-year period.
- Diagnosis confirmed via physical and radiologic examinations.
- Treatment strategies included observation, medication, arterial ligation, and surgical resection.
Main Results:
- Lesions were located in various sites including liver, face, neck, and mediastinum.
- All 22 children achieved complete cure.
- Treatment resulted in minimal patient morbidity.
Conclusions:
- Life-threatening hemangiomas in children can be successfully managed.
- Individualized treatment plans utilizing a range of techniques are effective.
- Early diagnosis and intervention are crucial for optimal outcomes.
Abstract:
Large hemangiomas in infants and children are rare but can be life-threatening if they involve vital structures or produce thrombocytopenia or congestive heart failure. During a 6-year period, 22 infants and children, aged newborn to 7 years, were treated for complex, symptomatic hemangiomas. The lesions were located in the liver in seven, face or parotid gland in five, neck in four, extremity in two, and mediastinum, chest wall-spinal cord, trachea, and retroperitoneum in one patient each. The diagnosis was suggested by physical examination in all patients and was confirmed by radiologic examination in most patients. The treatment was individualized, usually progressed from less to more invasive, and included observation, prednisone therapy, arterial ligation, and resection. All children were eventually cured, with minimal morbidity. Children with life-threatening hemangiomas can be successfully managed with the use of a variety of techniques.