A Multimodal Approach to a Complex PHACES Patient With Progressive Infantile Hemangioma: A Case Report and Review of
Evan D Hicks1, Muhammad Hameed1, Humam Shahare1
1Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, USA.
Insights
This case study details a complex infantile hemangioma and PHACES syndrome treatment in a neonate. Multimodal therapy, including beta-blockers and surgery, proved effective, highlighting the importance of multidisciplinary care.
Area of Science:
- Pediatric Dermatology
- Medical Genetics
- Vascular Anomalies
Background:
- Infantile hemangiomas are common benign vascular tumors in infants.
- PHACES syndrome is a rare, complex disorder associated with infantile hemangiomas, involving multiple organ systems.
- Management of extensive infantile hemangiomas in PHACES syndrome often requires a multidisciplinary approach.
Abstract:
A three-week-old baby presented with an infantile hemangioma in segmental beard distribution and evidence of PHACES syndrome (posterior fossa abnormalities, hemangiomas, arterial anomalies, cardiac abnormalities, eye anomalies, and sternal defects). Due to the progressive and symptomatic growth of infantile hemangioma, this patient required a multimodal treatment approach, including beta-blocker therapy, intralesional steroid injections, periorbital surgical debulking, airway interventions, and embolization. This report highlights a successful case of a complex PHACES patient that illustrates the significance of phased multidisciplinary care and emphasizes the importance of compliance. A literature review is included to highlight previously reported successful cases using alternative treatments to propranolol monotherapy. This case offers a unique insight into the timeline and outcomes of a PHACES patient with extensive disease requiring a multimodal approach and highlights possible disease presentation in the non-compliant or resistant patient.
