Fine clinical differences between patients with multifocal and diffuse hepatic hemangiomas.

Area of Science:

• Pediatric Hepatology
• Vascular Anomalies
• Medical Imaging

Background:

• Multifocal and diffuse hepatic hemangiomas are considered variants of infantile hemangiomas.
• A potential disease continuum exists between these hepatic hemangioma types.
• Understanding their differences is crucial for timely and appropriate treatment.

Purpose of the Study:

• To delineate similarities and differences between multifocal and diffuse hepatic hemangiomas.
• To identify specific multifocal hemangioma subgroups requiring prompt medical intervention.
• To investigate the potential continuum of disease phenotypes in infantile hepatic hemangiomas.

Main Methods:

• Retrospective analysis of 24 patients with multifocal or diffuse hepatic hemangiomas treated between 2000 and 2015.
• Classification of multifocal hemangiomas into countable (MC) and uncountable (MU) subgroups.
• Comparison of clinical presentations and outcomes between different hemangioma types and subgroups.

Main Results:

• Significant differences in hepatomegaly, heart failure, dyspnea, and hypothyroidism were observed between multifocal and diffuse types.
• The MU subgroup showed high similarity to the diffuse type in clinical presentation and treatment needs, differing only in hypothyroidism rates.
• Diffuse hepatic hemangiomas were associated with higher mortality risk, while the MC subgroup had the highest complete remission rates.

Conclusions:

• Diffuse hepatic hemangiomas represent a high-risk condition necessitating active treatment strategies.
• The MU subgroup of multifocal hepatic hemangioma shares characteristics with diffuse types, supporting a disease continuum.
• Timely identification and tailored treatment are essential for managing infantile hepatic hemangiomas effectively.