RSS-Feed abonnieren
DOI: 10.1055/s-0030-1261938
© Georg Thieme Verlag KG Stuttgart · New York
Multiple Hemangiomas and Hemangiomatosis – Risk Factors and Outcome over an Eight Year Period
Publikationsverlauf
received May 05, 2010
accepted after revision May 15, 2010
Publikationsdatum:
27. Juli 2010 (online)

Abstract
Introduction: Hemangiomas are the most common tumors of infancy. Multiple cutaneous hemangiomas may be associated with the presence of hemangiomas in inner organs. However, there is little data on the risk factors for organ involvement and the outcome of a large sample of patients.
Patients and Methods: patients with 3 or more cutaneous hemangiomas were evaluated with regard to patient characteristics, distribution of hemangiomas, results of radiological abdominal/cerebral imaging, clinical course, and therapeutic approach. We analyzed the risk factors for organ involvement and complications/outcome.
Results: The average gestational week at birth was 32.8; radiological imaging showed liver hemangiomas in 13.5% and mesenteric lesions in 1 (1.9%) but no cerebral lesions. Preterm infants (p=0.02) and patients with high numbers of cutaneous hemangiomas (p=0.02) were at higher risk of organ involvement. A life-threatening event occurred in 1 patient (1.9%). None of the patients died.
Conclusions: Organ manifestation is relatively common in patients with multiple hemangiomas, complications are rare, but potentially life-threatening. We recommend abdominal imaging for patients with 3 or more hemangiomas, especially in preterm infants.
Key words
hemangioma - hemangiomatosis - liver hemangioma - propranolol
References
- 1
Boye E, Yu Y, Paranya G. et al .
Clonality and altered behavior of endothelial cells from hemangiomas.
J Clin Invest.
2001;
107
745-752
MissingFormLabel
- 2
Smolinski KN, Yan C.
Hemangiomas of Infancy: Clinical and Biological Characteristics.
Clin Pediatr.
2005;
44
747-766
MissingFormLabel
- 3
Willenberg T, Baumgartner I.
Vascular Birthmarks.
Vasa.
2008;
37
5-17
MissingFormLabel
- 4
Dufau JP, le Tourneau A, Audouin J. et al .
Isolated diffuse hemangiomatosis of the spleen with Kasabach-Merritt-like syndrome.
Histopathology.
1999;
35
337-344
MissingFormLabel
- 5
Mridha AR, Chopra A, Chopra P. et al .
Diffuse neonatal hemangiomatosis without cutaneous involvement.
Acta Paediatr.
2006;
95
763-764
MissingFormLabel
- 6
Schulz AS, Urban J, Gessler P. et al .
Anaemia, thrombocytopenia and coagulopathy due to occult diffuse infantile hemangiomatosis
of spleen and pancreas.
Eur J Pediatr.
1999;
158
379-383
MissingFormLabel
- 7
Lopriore E, Markhorst DG.
Diffuse neonatal hemangiomatosis: new views on diagnostic criteria and prognosis.
Acta Paediatr.
1999;
88
93-97
MissingFormLabel
- 8
Boon LM, MacDonald DM, Mulliken JB.
Complications of systemic corticosteroid therapy for problematic hemangioma.
Plast Reconstr Surg.
1999;
104
1616-1623
MissingFormLabel
- 9
Darper H, Diamond I, Temple M.
Multimodal management of endangering hepatic hemangioma: impact on transplant avoidance:
a descriptive case series.
J Pediatr Surg.
2008;
434
120-126
MissingFormLabel
- 10
Ethundan M, Mellor TK.
Hemangiomas and vascular malformations of the maxillofacial region – a review.
Br J Oral Maxillofac Surg.
2006;
44
263-272
MissingFormLabel
- 11
Gottschling S, Schneider G, Meyer S. et al .
2 infants with life-threatening diffuse neonatal hemangiomatosis treated with cyclophosphamide.
Pediatr Blood Cancer.
2006;
46
239-242
MissingFormLabel
- 12
Isaacs H.
Fetal and neonatal hepatic tumors.
J Pediatr Surg.
2007;
42
1797-1803
MissingFormLabel
- 13
Léauté-Labrèze C, Dumas de la Roque E, Hubiche T. et al .
Propranolol for severe hemangiomas of infancy.
N Engl J Med.
2008;
358
2649-2651
MissingFormLabel
- 14
Sadan N, Wolach B.
Treatment of hemangiomas of infants with high doses of prednisone.
J Pediatr.
1996;
128
141-146
MissingFormLabel
- 15
Stillman AE, Hansen RC, Hallinan V. et al .
Diffuse neonatal hemangiomatosis with severe gastrointestinal involvement Favorable
response to steroid therapy.
Clin Pediatr.
1983;
22
589-591
MissingFormLabel
- 16
White CW.
Treatment of hemangiomatosis with recombinant interferon alfa.
Semin Hematol.
1990;
27
15-22
MissingFormLabel
- 17
Rohana J, Boo NY, Hayati AR. et al .
Diffuse neonatal hemangiomatosis: a rare cause of haemorrhagic shock and refractory
coagulopathy in the newborn.
Med J Malaysia.
2006;
57
364-367
MissingFormLabel
- 18
Golitz LE, Rudikoff J, O'Meara OP.
Diffuse neonatal hemangiomatosis.
Pediatr Dermatol.
1986;
3
145-152
MissingFormLabel
- 19
Enjolras O, Riche MC, Merland JJ. et al .
Management of alarming hemangiomas in infancy: A review of 25 cases.
Pediatrics.
1990;
85
491-498
MissingFormLabel
Correspondence
Dr. Christine Johanna Schupp
University Hospital Heidelberg
Pediatric Surgery
Kleine Mantelgasse 5
69117 Heidelberg
Germany
Telefon: +49 0176 2118 4370
eMail: Christine.Schupp@med.uni-heidelberg.de