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A Case Series of 18 Congenital Haemangiomas: Clinical, Histological and Ultrasound Features, and their Relationship
Gloria Juan-Carpena1, Juan Carlos Palazón-Cabanes2, Paloma Tallón-Guerola3
1Department of Dermatology, Alicante University General Hospital, Alicante, Spain; Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain; Department of Dermatology, Morales Meseguer University Hospital, Murcia, Spain. gloria5289@gmail.com.
Insights
Large congenital haemangiomas (CHs) over 5 cm are significantly linked to complications. Ultrasound findings like venous ectasia may also indicate higher risk, warranting further assessment.
Area of Science:
- Dermatology
- Pediatric Surgery
- Medical Imaging
Background:
- Congenital haemangiomas (CHs) are vascular tumors with variable clinical presentations.
- Understanding their characteristics is crucial for predicting complications and guiding management.
- Recent research highlights the importance of clinical, histological, and imaging features.
Purpose of the Study:
- To describe clinical, histological, and ultrasound features of CHs.
- To analyze the association between these features and complications or atypical behavior.
- To provide diagnostic and management recommendations for CHs.
Main Methods:
- Retrospective review of medical records, histology, and ultrasound images.
- Inclusion of patients diagnosed with CH between 2006 and 2021.
- Analysis of associations between CH characteristics and complications.
Main Results:
- 18 patients with CH were analyzed; 4 (22.2%) experienced complications, including one case of heart failure.
- Large CH size (>5 cm) showed a significant association with complications (p=0.019).
- Venous ectasia, venous lakes, and arteriovenous microshunts had borderline significant associations with complications (p=0.055).
Conclusions:
- Hematological and cardiological assessment is recommended for large CHs (>5 cm).
- Consider assessment for CHs with ultrasound findings of venous ectasia, venous lakes, or arteriovenous microshunts due to increased complication risk.
- Early identification of risk factors aids in timely intervention and improved patient outcomes.
Abstract:
Recent studies have advanced our understanding of the clinical, histological and imaging characteristics of congenital haemangiomas (CHs), and have reported possible complications and atypical behaviour. The aim of this study is to describe the clinical, histological and ultrasound features of a series of CHs and to analyse their association with complications and atypical behaviour, with a view to providing diagnostic and management recommendations. The medical records, histology results and ultrasound images of all patients with CH diagnosed in the Dermatology Department of Alicante University General Hospital between 2006 and 2021 were retrospectively reviewed. A total of 18 patients were included, of whom 4 (22.2%) had complications. The most severe was 1 case with heart failure. There was a significant association between large CH size (> 5 cm) and the occurrence of complications (p = 0.019). The study identified 3 different lobule patterns, but found no relationship with CH subtype or other findings. The associations of venous ectasia, venous lakes and arteriovenous microshunts with occurrence of complications was borderline significant (p = 0.055). Study limitations were the small sample and the retrospective analysis. To conclude, haematological and cardiological assessment is indicated in large CHs and should be considered in CHs with ultrasound findings of venous ectasia, venous lakes or arteriovenous microshunts, as these cases present a greater risk of complications.
