Segmental Infantile Hemangiomas That Involve the Midline Define Risk for LUMBAR Syndrome

A systematic review of clinical photographs from 91 patients with LUMBAR syndrome demonstrated that infantile hemangiomas in affected individuals were consistently segmental in morphology and involved the anatomic midline of the lumbosacral, sacrococcygeal, or pelvic regions. No cases were "partial segmental" or spared the midline. The hemangiomas were transmedian in all patients except one, in whom the hemangioma was unilateral and abutted the midline, and thus paramedian. These findings support the conclusion that segmental infantile hemangiomas involving the anatomic midline confer risk for LUMBAR syndrome and therefore warrant evaluation, while strictly lateral lesions without involvement of the midline do not. This refinement in risk stratification has immediate implications for clinical assessment and management.