Massive hemangioma in infants: therapeutic considerations

Area of Science:

• Pediatric Surgery
• Neonatal Medicine
• Vascular Anomalies

Background:

• Infantile hemangiomas are common vascular tumors in newborns.
• Symptomatic hemangiomas can cause severe complications like heart failure and platelet trapping.
• Treatment options for massive infantile hemangiomas are varied and outcomes can be serious.

Purpose of the Study:

• To evaluate the treatment outcomes for infants with massive symptomatic hemangiomas.
• To compare the effectiveness of different therapeutic modalities.

Main Methods:

• Retrospective review of eight infants treated for massive symptomatic hemangiomas over six years.
• Analysis of treatment interventions including prednisone, surgical excision, radiation therapy, and arteriographic embolization.
• Assessment of clinical outcomes, including resolution of symptoms and mortality.

Main Results:

• Five infants had hepatic hemangiomas; others had lesions on the arm, leg, or face.
• Congestive heart failure occurred in six infants; platelet trapping in three.
• Prednisone and surgery were effective in six infants.
• Two infants died due to sepsis, heart failure, and platelet trapping.
• Radiation and embolization showed limited efficacy.

Conclusions:

• Combined prednisone and surgical excision offer a potentially curative approach for massive symptomatic infantile hemangiomas.
• Early and aggressive management is crucial due to the risk of severe complications and mortality.
• Further research into optimal treatment strategies is warranted.