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Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon

Congenital hemangiomas (CHs) are rare vascular tumors and do not exhibit progressive postnatal growth. The incidence is less than 3% of all hemangiomas. Most CHs have a favorable prognosis; however, the Kasabach–Merritt phenomenon (KMP) is a rare but life-threatening complication in CHs that require...

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Autores principales: Peng, Ying-Hsuan, Lin, Ming-Chih, Liu, Wei-Li, Jan, Sheng-Ling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10002418/
https://www.ncbi.nlm.nih.gov/pubmed/36911036
http://dx.doi.org/10.3389/fped.2023.1073090
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author Peng, Ying-Hsuan
Lin, Ming-Chih
Liu, Wei-Li
Jan, Sheng-Ling
author_facet Peng, Ying-Hsuan
Lin, Ming-Chih
Liu, Wei-Li
Jan, Sheng-Ling
author_sort Peng, Ying-Hsuan
collection PubMed
description Congenital hemangiomas (CHs) are rare vascular tumors and do not exhibit progressive postnatal growth. The incidence is less than 3% of all hemangiomas. Most CHs have a favorable prognosis; however, the Kasabach–Merritt phenomenon (KMP) is a rare but life-threatening complication in CHs that requires aggressive treatment. Medical treatments with corticosteroids and interferon have been suggested. Surgical resection can be considered for the treatment of complicated CHs in medically resistant lesions. Vascular embolization could be an alternative method if surgery is not considered feasible. Herein, we report a case of a 9-day-old newborn who underwent arterial embolization for a CH with KMP, combined with sirolimus treatment, and the outcome was favorable. The hemangioma completely regressed by 3 months and rapidly involuting congenital hemangioma (RICH) was diagnosed. Our successful experience with treating RICH associated with KMP revealed that RICH can have potentially serious complications although they usually resolve rapidly after birth without treatment. Surgical resection is considered to be the standard method for the treatment of medically resistant vascular tumors, but it is difficult to perform during the active phase of KMP due to acute bleeding and severe coagulopathy. Arterial embolization is feasible and can be used as an alternative to surgical resection, even in small babies.
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spelling pubmed-100024182023-03-11 Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon Peng, Ying-Hsuan Lin, Ming-Chih Liu, Wei-Li Jan, Sheng-Ling Front Pediatr Pediatrics Congenital hemangiomas (CHs) are rare vascular tumors and do not exhibit progressive postnatal growth. The incidence is less than 3% of all hemangiomas. Most CHs have a favorable prognosis; however, the Kasabach–Merritt phenomenon (KMP) is a rare but life-threatening complication in CHs that requires aggressive treatment. Medical treatments with corticosteroids and interferon have been suggested. Surgical resection can be considered for the treatment of complicated CHs in medically resistant lesions. Vascular embolization could be an alternative method if surgery is not considered feasible. Herein, we report a case of a 9-day-old newborn who underwent arterial embolization for a CH with KMP, combined with sirolimus treatment, and the outcome was favorable. The hemangioma completely regressed by 3 months and rapidly involuting congenital hemangioma (RICH) was diagnosed. Our successful experience with treating RICH associated with KMP revealed that RICH can have potentially serious complications although they usually resolve rapidly after birth without treatment. Surgical resection is considered to be the standard method for the treatment of medically resistant vascular tumors, but it is difficult to perform during the active phase of KMP due to acute bleeding and severe coagulopathy. Arterial embolization is feasible and can be used as an alternative to surgical resection, even in small babies. Frontiers Media S.A. 2023-02-24 /pmc/articles/PMC10002418/ /pubmed/36911036 http://dx.doi.org/10.3389/fped.2023.1073090 Text en © 2023 Peng, Lin, Liu and Jan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Peng, Ying-Hsuan
Lin, Ming-Chih
Liu, Wei-Li
Jan, Sheng-Ling
Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon
title Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon
title_full Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon
title_fullStr Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon
title_full_unstemmed Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon
title_short Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon
title_sort case report: transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and kasabach–merritt phenomenon
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10002418/
https://www.ncbi.nlm.nih.gov/pubmed/36911036
http://dx.doi.org/10.3389/fped.2023.1073090
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