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Congenital haemangiomas: a single-centre retrospective review
Victoire Braun1, Sorilla Prey1,2, Carlotta Gurioli3
1Dermatology, CHU de Bordeaux, Bordeaux, France.
Insights
Congenital haemangiomas (CHs) present in three subtypes: rapidly involuting CHs (RICHs), non-involuting CHs (NICHs), and partially involuting CHs (PICHs). These subtypes share overlapping clinical and paraclinical features, suggesting they are part of a single pathological spectrum.
Area of Science:
- Dermatology
- Pediatric Oncology
- Vascular Biology
Background:
- Congenital haemangiomas (CHs) are vascular tumors present at birth.
- Three subtypes exist: rapidly involuting CHs (RICHs), non-involuting CHs (NICHs), and partially involuting CHs (PICHs).
Purpose of the Study:
- To explore the clinical, evolutionary, and paraclinical characteristics of the three CH subtypes.
- To investigate the relationship between RICH, NICH, and PICH.
Main Methods:
- Retrospective study of 57 patients with CHs over 13 years.
- Review of epidemiological, clinical, and evolutionary data, photographs, and imaging.
- Histological examination of available tissue samples.
Main Results:
- CHs predominantly affected males and were most common on limbs.
- RICH, NICH, and PICH showed overlapping features, including telangiectatic lesions and pale halos.
- NICHs were flat at birth, while RICHs and PICHs were bulky; RICHs involuted by 12 months, and PICHs frequently ulcerated and caused pain.
Conclusions:
- CH subtypes share overlapping characteristics, supporting the hypothesis that they exist on a single pathological spectrum.
- Clinical presentation and evolution vary, with some RICHs progressing to PICHs.
Objective:
Congenital haemangiomas (CHs) are rare, benign vascular tumours that are fully developed at birth. Three subtypes of CHs have been described based on clinical behaviour: rapidly involuting CHs (RICHs), non-involuting CHs (NICHs) and partially involuting CHs (PICHs). We explore in our study clinical, evolutionary and paraclinical characteristics of the three CH subtypes.
Design:
Children with CH attending our department of paediatric dermatology at Bordeaux University Hospital over a 13-year period were retrospectively included. Epidemiological, clinical and evolutionary data, photographs and imaging results were reviewed. All available tissue samples were histologically examined.
Results:
We included 57 patients: 22 with RICH, 22 with NICH and 13 with PICH. Males predominated (ratio 1.7); the most common CH location was on the limbs. RICH, NICH and PICH exhibited overlapping characteristics; all were single telangiectatic lesions with pale peripheral halos. At birth, NICHs were flat but RICHs and PICHs bulky. The median age at complete RICH involution was 12 months. One-third of CHs that appeared RICH-like at birth underwent incomplete involution to become PICHs. Heart failure and thrombocytopenia were rare complications. PICHs were frequently ulcerated. Pain was common for NICH and PICH. The imaging and histological data of the three CH subtypes were rather similar.
Conclusions:
We describe the characteristics and evolution of the three CH subtypes using a case series. Certain overlapping features were apparent, reinforcing the hypothesis that RICH, NICH and PICH lie on the same pathological spectrum.
