Preterm neonate with a large congenital hemangioma on maxillofacial site causing thrombocytopenia and heart failure: A case report

Abstract

BACKGROUND We report a rare case of a large congenital hemangioma (CH) in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure. With close multidisciplinary collaboration, the congenital hemangioma was successfully resected with good results. CASE SUMMARY The patient was delivered at gestational age of 36 wk by cesarean section due to cephalopelvic disproportion and lack of onset of labor (birth weight: 2630 g). A right-sided facial tumor was detected in the fetus during routine antenatal ultrasound examination of the mother at 32 wk of gestation. Physical examination revealed a 7 cm × 7 cm × 3 cm hard, dull purple-colored mass on the right maxillofacial region. The mass was tense and had prominent surface telangiectasias. Laboratory investigations revealed reduced hemoglobin and platelet count, and increased activated partial thromboplastin time, prothrombin time, and thrombin time. International normalized ratio, fibrin degradation products, and D-Dimer levels were significantly increased. Thromboelastography showed increased alpha angle, mean amplitude, and the clot formation speed. Thyroid-stimulating hormone level was significantly elevated. The patient was administered prednisone, propranolol, euthyrox, vitamin K1, milrinone, and digoxin. After operation, cefepime was administered for anti-infection and propranolol was prescribed at discharge. CONCLUSION We report a rare case of CH in the right maxillofacial region causing thrombocytopenia and heart failure.

Novel organoid construction strategy for non-involuting congenital hemangioma for drug validation

“…However, the effect of propranolol is controversial in NICH therapy. Some research has claimed that propranolol is effective in the early stage of NICH, while other investigators have claimed that propranolol is invalid for NICH 24 Interestingly, in this study, the results indicated that propranolol (Figure 6A) did not have a signi cant therapeutic effect on NICH organoids even at high dosages (160 μg/L). Moreover, neither sirolimus (Figure 6B) nor trametinib (Figure 6C) at different dosages had any appreciable effect on NICH organoid models, which indicates that more organoids need further drug screening.…”

“…Additional research is required to identify optimal medical therapies to enhance other interventional approaches for high-risk patients 29 . Propranolol has been demonstrated to be successful in the treatment of IH, and it has been claimed that NICH can be treated with propranolol alone without causing major side effects 24 . However, additional studies revealed that propranolol was ineffective for treating NICH or PICH 29,31−33 .…”