Large parotid and cheek infantile hemangiomas refractory to medical treatment: Is there a role for embolization?

Abstract

Objectives: The aim of this study was to evaluate the results of transarterial embolization (TAE) as a stand-alone treatment for large parotid and cheek infantile hemangiomas (IHs) that are refractory to medical treatment. Material and Methods: We retrospectively reviewed patients with head and neck IHs who underwent TAE at two single tertiary centers. We then analyzed the clinical and angiographic data of those patients with IHs located in the parotid and/or cheek regions. Results: A total of 38 patients with head and neck IHs were treated with TAE. Sixteen patients had a follow-up 2 months or more after treatment; from these patients, 6 IHs were located in the parotid or cheek regions. Four of the six tumors were in the proliferative phase. After TAE, almost 100% of angiographic obliteration of the IHs was attained. There was a complete shrinking of the tumor mass in all patients within a period of 2–5 months. One partially reversible complication occurred. Conclusion: Our preliminary results showed that TAE may be a useful therapeutic treatment not only before surgery but also as upfront and definitive therapy for parotid and cheek IHs.

A multi-step approach to the treatment of giant scalp congenital hemangiomas: a report of two cases

“…Plascencia ( 15 ) supported the evidence from other authors. He mentioned that maxillofacial vascular tumors can be treated with TAE and supported that the size of hemangiomas in all 6 cases shrank by 100% within 6 months.…”

Cavernous Hemangioma in the Parotid Gland of an Adult: A Case Report and Review of Literature

“…Adult parotid gland hemangiomas do not regress, thus surgical intervention is required in contrast to infantile hemangiomas that could involute or be treated non-surgically with sclerotherapy, propranolol, intralesional, or systemic corticosteroids [ 6 , 20 , 21 ]. Preoperative embolization is important for minimizing the size of large hemangiomas, as well as intraoperative bleeding [ 20 ]. Non-surgical therapies are only considered in adults if surgery is not an option.…”

Three Cases of Parotid Hemangiomas in Adults

“…Preoperative transarterial embolization is advisable in large and well-vascularized tumors to reduce tumor size and intraoperative bleeding. 23 For infantile hemangiomas, other nonsurgical treatments have been developed, including endovascular sclerotherapy and the administration of vincristine, propranolol, or intralesional or systemic corticosteroids. However, the effectiveness of these treatments for cavernous hemangiomas remains unclear.…”