Propranolol Therapy for an Abdominal Giant Haemangioma in a Neonate

Abstract

A one day old Moroccan boy was admitted to our neonatal unit with a giant tuberous right abdominal haemangioma. The clinical examination revealed no other vascular tumours. There was no evidence of heart failure. Ultrasound and MRA documented a giant vascular structure suggestive of haemangioma. The tumor responded well to propranolol treatment.J Nepal Paediatr Soc 2015;35(2):189-191

Successful Use of Propranolol in a Symptomatic Giant Congenital Hepatic Hemangioma

“…11 In CHH, the reported use varies from 40 days to 1 year. 16, 33, 34 In our patient, she received 9 months of propranolol with tumor reduction of more than 50% at the last US combined with short priming of corticosteroid therapy, because it has shown improvement in the involution for cutaneous 36 and hepatic hemangiomas. 16, 30, 37…”

“…13, 15, 25, 29-32 Propranolol is the therapy of choice for infantile hemangiomas, 10-12 and these findings have been extrapolated for hepatic or visceral hemangiomas. In CHH, its use has had mixed results with partial, complete, or no improvement; 16, 30, 33-35 however, because most CHH involute, the effect may not be entirely attributed to the medication.…”

“…Case reports vary from an initial dose of 0.16 mg/kg/day to 3.5 mg/kg/day with gradual increments of 2 or 3 mg/kg/day, into 2 or 3 divided doses. 12, 16, 30, 31, 33, 34 Moreover, there is no consensus on the optimal duration of treatment with propranolol. Duration depends on the specific case and tolerance of the medication.…”

Treatment of Symptomatic Focal Hepatic Hemangioma with Propranolol in Neonates: Is It Efficient?

“…For focal HH that is mostly assumed to be CHH, drug treatment is not recommended; in cases of shunting with high flow and high output cardiac failure, embolization [ 3 ], or alternatively steroid treatment or surgical excision is proposed [ 4 6 7 ]. Considering the successful management of focal HH with propranolol reported in the literature [ 8 9 10 11 12 13 ], we believe that the current treatment recommendations for focal HH should be redefined.…”