Basic dermatology in children and adolescents
Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo in Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Hemangiomas follow a benign course; for uncomplicated lesions, observation is recommended. For hemangiomas that ulcerate, disfigure the patient, or start to compress vital structures, the patient should be referred to a dermatologist, and treatment with topical timolol or oral propranolol should be considered. For residual telangiectasias, pulsed-dye laser therapy can be used. Hemangiomas that occur in the lumbosacral region can potentially be associated with spinal, bony, and genitourinary abnormalities and should be investigated accordingly. Hemangiomas that occur in a segmental distribution on the face or neck can be associated with arterial, cardiac, neurologic, and eye abnormalities (PHACE syndrome). When PHACE syndrome is considered in the differential diagnosis, urgent referral to a dermatologist is recommended.
Soft Tissues
Joseph Kovi, Hung Dinh Duong in Frozen Section In Surgical Pathology: An Atlas, 2019
DIFFERENTIAL DIAGNOSIS: ClinicalThe so-called “cystic hygroma” of the neck is the best known example of the tumor. The lesion can be easily differentiated from cervical lymphadenopathy by palpation.MicroscopicLymphangioma is composed of narrow or dilated, thick-walled lymphatic channels containing lymph. In various forms of hemangioma there are red blood cells present in the vessels. The lymphatic channels of lymphangioma are generally associated with collections of lymphocytes. This feature is not noted in hemangioma.
Benign lesions
Richard P. Usatine, Daniel L. Stulberg, Graham B. Colver in Cutaneous Cryosurgery, 2014
Strawberry hemangiomas in newborn babies can be treated with a cryoprobe applied firmly to the lesion with a contact gel interface for a period of 10–20 s. The aim is to allow the rim of ice to spread for up to 2 mm on to the normal surrounding skin.15 Of course, cryosurgery is painful to the infant who does not understand the purpose of the treatment. It has the risks of hypopigmentation and scarring. Since the advent of oral and topical β-blocker treatment the use of cryosurgery for infantile hemangiomas has fallen out of favor. Oral propranolol has proven to be a very effective treatment. However, a small percentage of hemangiomas do not respond and cryosurgery remains an option for these lesions and others that have persisted into adulthood (Figure 8.18).
KTP laser alone or combined with bleomycin for pharyngolaryngeal hemangioma: a lesion grade-based determination of prognosis
Published in Acta Oto-Laryngologica, 2023
Min Shu, Peijie He, Chunsheng Wei
Bleomycin is a conventional chemotherapy that induces DNA degradation by affecting the G2 and S phases of mitotic cells [18]. It can be used alone for the treatment of hemangioma. No study is available about the combined use of bleomycin and the KTP laser, but a study suggested the benefits of bleomycin combined with the electroresection of hemangiomas [19]. A study also suggested the benefits of CO2 laser combined with pingyangmycin for pharyngeal and laryngeal hemangiomas [20]. This study suggests that combining the KTP laser and bleomycin might not improve the treatment outcomes, although theoretically, for the lesions with a large cross-sectional area, bleomycin injection will be effective on the deep layer, while the shallow layer will respond to the laser treatment. Therefore, further study is warranted to determine the efficacy of combining the two methods.
Multifocal infantile hemangioma of the eyelid causing amblyopia requiring surgical resection
Published in Baylor University Medical Center Proceedings, 2023
Kimberly Nguyen, Aliza Epstein, Donovan S. Reed, Lani Hoang, Marie Somogyi
Benign infantile vascular lesions can present a diagnostic challenge due to the broad differential diagnosis, including congenital disseminated pyogenic granuloma, multifocal lymphangioendotheliomatosis with thrombocytopenia, Kasabach-Merritt syndrome, and multifocal infantile hemangiomas, formerly known as diffuse neonatal hemangiomatosis.1–4 Infantile hemangiomas are the most common vascular tumors in infancy, affecting 3% to 10% of Caucasian infants.4 Approximately 80% of cases are singular lesions that appear within the first 2 weeks of life, primarily on the head and neck (60%), trunk (25%), or extremities (15%).5 Infantile hemangioma may also be categorized as segmental or multifocal, the latter representing a minority (3.6%) of all infantile hemangioma cases and more likely to involve extracutaneous lesions.4
Clinical and Pathological Features of Congenital Hepatic Hemangioma in Children: A Retrospective Analysis
Published in Fetal and Pediatric Pathology, 2023
Rong Wen, Zheng-Zhen Zhou, Wei-Jian Chen
CHH begins to proliferate in utero and usually peaks before or at birth. In this group, 18 children were full-term infants. Liver masses were detected prenatally by ultrasound in eight cases. The course of the disease ranged from 1 day to 5 years. Only two cases were longer than 1 year and the tumor was noninvolution. The tumor may occur in any lobe of the liver or involve two lobes. It is usually a solitary mass. Imaging showed that the ratio between the left and right lobes was 6:5. Serum AFP was obtained in 17/22 patients, 9/17 were elevated, with five cases decreasing to normal before operation, 8/17 were normal. The changes in serum AFP levels were helpful for clinical differentiation between benign and malignant tumors. In CHH, AFP levels may be elevated but do not persist [4]. In hepatoblastoma, it will continue to produce AFP [5]. Seventeen children in this group developed anemia to varying degrees and one case had decreased platelet count, but it was not a KM (Kasabach-Merritt) phenomenon. Some hepatic hemangiomas can cause life-threatening complications, such as high-flow heart failure and hypothyroidism. In this group, one patient had coagulopathy and one patient had diffuse intravascular coagulation. There was one case with hyperthyroidism.
Related Knowledge Centers
- Benign Tumor
- Beta Blocker
- Cavernous Hemangioma
- Empagliflozin
- Vascular Tumor
- Endothelium
- Liver
- Propranolol
- Infantile Hemangioma
- Medical Imaging