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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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1073090/full |
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| author | Ying-Hsuan Peng Ying-Hsuan Peng Ming-Chih Lin Wei-Li Liu Sheng-Ling Jan Sheng-Ling Jan |
| author_facet | Ying-Hsuan Peng Ying-Hsuan Peng Ming-Chih Lin Wei-Li Liu Sheng-Ling Jan Sheng-Ling Jan |
| author_sort | Ying-Hsuan Peng |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-10T07:26:49Z |
| format | Article |
| id | doaj.art-d49f1977f69a49bea54c87b183dbfac3 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-10T07:26:49Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-d49f1977f69a49bea54c87b183dbfac32023-02-24T06:14:28ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-02-011110.3389/fped.2023.10730901073090Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenonYing-Hsuan Peng0Ying-Hsuan Peng1Ming-Chih Lin2Wei-Li Liu3Sheng-Ling Jan4Sheng-Ling Jan5Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanDepartment of Pediatrics, School of Medicine, Chung Shan Medical University, Taichung, TaiwanDepartment of Pediatrics, Children's Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Pediatrics, Dalin Tzu Chi Hospital, Chiayi, TaiwanDepartment of Pediatrics, Children's Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Pediatrics, School of Medicine, National Yang-Ming University and Kaohsiung Medical University, Hsinchu and Kaohsiung, TaiwanCongenital 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.https://www.frontiersin.org/articles/10.3389/fped.2023.1073090/fullcongenital hemangiomaKasabach–Merritt phenomenoncoagulopathytransarterial embolizationinfants |
| spellingShingle | Ying-Hsuan Peng Ying-Hsuan Peng Ming-Chih Lin Wei-Li Liu Sheng-Ling Jan Sheng-Ling Jan Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach–Merritt phenomenon Frontiers in Pediatrics congenital hemangioma Kasabach–Merritt phenomenon coagulopathy transarterial embolization infants |
| 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 | congenital hemangioma Kasabach–Merritt phenomenon coagulopathy transarterial embolization infants |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1073090/full |
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