Multifocal infantile haemangioma: a diagnostic challenge

Abstract

We describe a case of a newborn who presented with multiple dark red macules that developed into red-to-purple papules associated with thrombocytopaenia. Abdominal ultrasound showed multiple hyperechoic papules and nodules. Endothelial cells from a skin biopsy stained positively for endothelial cell glucose transporter 1, which was consistent with a diagnosis of multifocal infantile haemangioma. At the age of 2 months, the child developed intestinal bleeding and anaemia. Upper and lower endoscopies showed no intestinal haemangiomas. Oral treatment with propranolol (3 mg/kg/day) resulted in complete involution of the skin and hepatic haemangiomas over the period of treatment, which lasted until the child was aged 15 months. This is a rare case of multifocal cutaneous haemangioma with hepatic and probable intestinal involvement, successfully treated with propranolol.

Diffuse hepatocutaneous hemangiomatosis: an unusual presentation

“…A multicenter prospective study revealed that 16% of children with 5 or more IHs had single or multiple hepatic hemangiomas, and 1.3% had hemangiomas in the gastrointestinal tract or in the respiratory system (7) . Soukoulis et al and Torres et al reported diffuse hepatocutaneous hemangiomatosis associated with gastrointestinal tract hemangiomas in three patients (6,8) . The severity spectrum associated with diffuse hepatocutaneous hemangiomatosis varies widely and ranges from asymptotic presentation to death.…”

“…The presence of multiple cutaneous hemangiomas in the newborn has been associated with organ -and especially liver -involvement. Other locations such as the gastrointestinal tract, the central nervous system, the respiratory system, the eyes, and even the peritoneum have also been reported, but less frequently (1)(2)(3)(4)(5)(6) . A multicenter prospective study revealed that 16% of children with 5 or more IHs had single or multiple hepatic hemangiomas, and 1.3% had hemangiomas in the gastrointestinal tract or in the respiratory system (7) .…”

Model of Predicting the Effectiveness of Hemangioma Treatment in Children

“…Множинні ураження спостерігаються майже у 20 % випадків і можуть траплятися у сполученні з ураженнями внутрішніх органів. Близько 60 % гемангіом локалізуються в косметично і життєво значущих зонах обличчя та шиї [5,6,7]. Поширені гемангіоми, гемангіоми з глибоким проростанням, ураженням естетичних і вітальних структур потребують прецензійної діагностики для виключення злоякісної природи, а також індивідуального підбору терапії [8,9].…”