Perinatal subglottic and hepatic hemangiomas as potential emergencies: effect of radiotherapy

The authors analyze 5 cases of perinatal hemangiomas in internal localizations respresenting relative or immediate emergencies. Three cases were subglottic proliferating hemangiomas with threatening suffocation, the other two were large hemangiomas of the liver causing conspicuous hepatomegaly. In 3 children there were also hemangiomas of the skin and/or in the oral cavity seen as important signs in the diagnostic reflections on the nature of the urgent clinical pictures. Moreover one child with subglottic hemangioma suffered from hematological disorders characterizing the syndrome Kasabach--Merritt. In all the children transcutaneous radiotherapy was performed (ranging from 12 Gy in two weeks up to an exceptional dose of 25 Gy over 3 months). This was followed by recession of subjective complaints and, eventually, by complete regression of the irradiated angiomatous lesions, both subglottic and hepatic. The disorders of hemocoagulation disappeared also quickly and completely. At present, i. e. after 3 to 21 years, there are no undersirable post-irradiation changes in any of the patients. Nevertheless, in view of possible post-irradiation effects, particularly on the thyroid gland, the patients continue to be regularly followed up at the respective clinical departments.