Oral propranolol as a new treatment for facial infantile hemangioma: case report

Abstract

Hemangiomas are the most common benign tumors of infancy. Despite their self-limited course, infantile capillary hemangiomas can impair vital or sensory functions as vision and cause cosmetic deformity. The usual treatments include oral/intralesional steroids, alpha interferon, cytotoxins, pulsed dye laser and cosmetic surgery resection. These treatments are not free of multiple complications and toxic side effects. This report describes the case of a 3-month-old female baby with progressively increasing hemangioma of the left upper eyelid impinging over the visual field. The hemangioma promptly responded to low-dose oral propranolol. A clinical response was noticed few days after the beginning of the treatment, with regression to 1/4 of its original size in 45 days of treatment, and to less than 1/10 after 8 months, free of any major side effects.

Propranolol in Use for Treatment of Complex Infant Hemangiomas: Literature Review Regarding Current Guidelines for Preassessment and Standards of Care before Initiation of Therapy

“…This has been in coincidence with the results of another two reports published in the following year by Da Cruz Ferreira et al [44] and Kim and coworkers, respectively [50]. …”

“…Regarding our aim to find or develop a uniform and accepted “guideline” or “protocol for treatment” in daily clinical practice, Da Cruz Ferreira et al stated in 2011 that “we did not follow any specific protocol for treatment, because at the time we treated this first baby there were no protocols” [44]. …”

“…Indications listed so far for propranolol therapy are large (facial) hemangiomas with endangering localization and large segmental hemangiomas on the trunk and extremities [6, 11, 28, 31, 33, 41, 44, 52]. However, treatment should start as early as in the proliferation phase [28, 58].…”