Absolute ethanol embolotherapy for hemangioma with Kasabach-Merritt syndrome

This report describes a female baby having a hemangioma over the right thigh that had appeared as an irregular bruise since two days old. Severe thrombocytopenia, consumptive coagulopathy, anemia, and heart failure developed at three months old. With a diagnosis of Kasabach-Merritt syndrome, systemic corticosteroid, vincristine, subcutaneous alpha-interferon, and massive plate transfusion were given. However, the platelet count remained low and the skin lesion enlarged gradually. Trans-feeding-arterial embolotherapy with a 5 ml pure ethanol (1 ml/kg) injection was performed at four months of age. Thirty days later, her platelet count recovered and the hemangioma shrunk in size. This case illustrates that absolute ethanol embolotherapy is an effective treatment for hemangioma with Kasabach-Merritt syndrome and may be life-saving for those with lesions refractory to medical therapy.