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The changing face of complicated infantile hemangioma treatment

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Abstract

Infantile hemangiomas are the most common vascular tumors of infancy. A multidisciplinary approach including dermatologists, otolaryngologists, plastic surgeons, hematologists/oncologists and interventional/diagnostic radiologists is crucial for appropriate management of children with complicated infantile hemangiomas. Since its unforeseen discovery in 2008, propranolol has become the first-line treatment for infantile hemangiomas, eclipsing systemic corticosteroids and radiologic intervention. There are still, however, uncommon indications for more aggressive interventional management. We review the 2014-updated International Society for the Study of Vascular Anomalies (ISSVA) classification for vascular anomalies. Additionally, we suggest management algorithms for complicated lesions, including recommendations for radiologic and surgical intervention.

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References

  1. Munden A, Butschek R, Tom WL et al (2014) Prospective study of infantile haemangiomas: incidence, clinical characteristics and association with placental anomalies. Br J Dermatol 170:907–913

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Mueller BU, Mulliken JB (1999) The infant with a vascular tumor. Semin Perinatol 23:332–340

    Article  CAS  PubMed  Google Scholar 

  3. Frieden IJ, Haggstrom AN, Drolet BA et al (2005) Infantile hemangiomas: current knowledge, future directions. Proceedings of a research workshop on infantile hemangiomas, April 7–9, 2005, Bethesda, MD. Pediatr Dermatol 22:383–406

    Article  PubMed  Google Scholar 

  4. Amir J, Metzker A, Krikler R et al (1986) Strawberry hemangioma in preterm infants. Pediatr Dermatol 3:331–332

    Article  CAS  PubMed  Google Scholar 

  5. Malan E, Puglionisi A (1964) Congenital angiodysplasias of the extremities. I. Generalities and classification: venous dysplasias. J Cardiovasc Surg 5:87–130

    CAS  Google Scholar 

  6. Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422

    Article  CAS  PubMed  Google Scholar 

  7. Jackson IT, Carreno R, Potparic Z et al (1993) Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment. Plast Reconstr Surg 91:1216–1230

    Article  CAS  PubMed  Google Scholar 

  8. Wassef M, Blei F, Adams D et al (2015) Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics 136:e203–e214

    Article  PubMed  Google Scholar 

  9. Leon-Villapalos J, Wolfe K, Kangesu L (2005) GLUT-1: an extra diagnostic tool to differentiate between haemangiomas and vascular malformations. Br J Plast Surg 58:348–352

    Article  CAS  PubMed  Google Scholar 

  10. Lopez Gutierrez JC, Tovar JA, Patron M (2005) The impact of Glut-1 marker application on the diagnosis and treatment of congenital vascular anomalies. Cir Pediatr 18:113–120

    CAS  PubMed  Google Scholar 

  11. Chamlin SL, Haggstrom AN, Drolet BA et al (2007) Multicenter prospective study of ulcerated hemangiomas. J Pediatr 151:684–689

    Article  PubMed  Google Scholar 

  12. Haggstrom AN, Drolet BA, Baselga E et al (2006) Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment. Pediatrics 118:882–887

    Article  PubMed  Google Scholar 

  13. Paltiel HJ, Burrows PE, Kozakewich HP et al (2000) Soft-tissue vascular anomalies: utility of US for diagnosis. Radiology 214:747–754

    Article  CAS  PubMed  Google Scholar 

  14. Kassarjian A, Zurakowski D, Dubois J et al (2004) Infantile hepatic hemangiomas: clinical and imaging findings and their correlation with therapy. AJR Am J Roentgenol 182:785–795

    Article  PubMed  Google Scholar 

  15. Azizkhan RG (2013) Complex vascular anomalies. Pediatr Surg Int 29:1023–1038

    Article  PubMed  Google Scholar 

  16. Lee BB, Choe YH, Ahn JM et al (2004) The new role of magnetic resonance imaging in the contemporary diagnosis of venous malformation: can it replace angiography? J Am Coll Surg 198:549–558

    Article  PubMed  Google Scholar 

  17. Breugem CC, Maas M, Reekers JA et al (2001) Use of magnetic resonance imaging for the evaluation of vascular malformations of the lower extremity. Plast Reconstr Surg 108:870–877

    Article  CAS  PubMed  Google Scholar 

  18. Dobson MJ, Hartley RW, Ashleigh R et al (1997) MR angiography and MR imaging of symptomatic vascular malformations. Clin Radiol 52:595–602

    Article  CAS  PubMed  Google Scholar 

  19. Smith JK, Castillo M, Wilson JD (1995) MR characteristics of low-flow facial vascular malformations in children and young adults. Clin Imaging 19:109–117

    Article  CAS  PubMed  Google Scholar 

  20. Gorincour G, Kokta V, Rypens F et al (2005) Imaging characteristics of two subtypes of congenital hemangiomas: rapidly involuting congenital hemangiomas and non-involuting congenital hemangiomas. Pediatr Radiol 35:1178–1185

    Article  PubMed  Google Scholar 

  21. Konez O, Burrows PE, Mulliken JB et al (2003) Angiographic features of rapidly involuting congenital hemangioma (RICH). Pediatr Radiol 33:15–19

    Article  PubMed  Google Scholar 

  22. Legiehn GM, Heran MK (2006) Classification, diagnosis, and interventional radiologic management of vascular malformations. Orthop Clin N Am 37:435–474

    Article  Google Scholar 

  23. Lowe LH, Marchant TC, Rivard DC et al (2012) Vascular malformations: classification and terminology the radiologist needs to know. Semin Roentgenol 47:106–117

    Article  PubMed  Google Scholar 

  24. Roebuck D, Sebire N, Lehmann E et al (2012) Rapidly involuting congenital haemangioma (RICH) of the liver. Pediatr Radiol 42:308–314

    Article  PubMed  Google Scholar 

  25. Moukaddam H, Pollak J, Haims AH (2009) MRI characteristics and classification of peripheral vascular malformations and tumors. Skeletal Radiol 38:535–547

    Article  PubMed  Google Scholar 

  26. Ballah D, Cahill AM, Fontalvo L et al (2011) Vascular anomalies: what they are, how to diagnose them, and how to treat them. Curr Probl Diagn Radiol 40:233–247

    Article  PubMed  Google Scholar 

  27. Aboutalebi A, Jessup CJ, North PE et al (2012) Histopathology of vascular anomalies. Facial Plast Surg 28:545–553

    Article  CAS  PubMed  Google Scholar 

  28. Bivings L (1954) Spontaneous regression of angiomas in children; twenty-two years’ observation covering 236 cases. J Pediatr 45:643–647

    Article  CAS  PubMed  Google Scholar 

  29. Sadan N, Wolach B (1996) Treatment of hemangiomas of infants with high doses of prednisone. J Pediatr 128:141–146

    Article  CAS  PubMed  Google Scholar 

  30. Enjolras O, Riche MC, Merland JJ et al (1990) Management of alarming hemangiomas in infancy: a review of 25 cases. Pediatrics 85:491–498

    CAS  PubMed  Google Scholar 

  31. Bennett ML, Fleischer AB Jr, Chamlin SL et al (2001) Oral corticosteroid use is effective for cutaneous hemangiomas: an evidence-based evaluation. Arch Dermatol 137:1208–1213

    Article  CAS  PubMed  Google Scholar 

  32. Zarem HA, Edgerton MT (1967) Induced resolution of cavernous hemangiomas following prednisolone therapy. Plast Reconstr Surg 39:76–83

    Article  CAS  PubMed  Google Scholar 

  33. Chim H, Gosain AK (2011) Discussion: oral prednisolone for infantile hemangioma: efficacy and safety using a standardized treatment protocol. Plast Reconstr Surg 128:753–754

    Article  CAS  PubMed  Google Scholar 

  34. Gunn T, Reece ER, Metrakos K et al (1981) Depressed T cells following neonatal steroid treatment. Pediatrics 67:61–67

    CAS  PubMed  Google Scholar 

  35. Christison-Lagay ER, Fishman SJ (2006) Vascular anomalies. Surg Clin North Am 86:393–425

    Article  PubMed  Google Scholar 

  36. Egbert JE, Nelson SC (1997) Neurologic toxicity associated with interferon alfa treatment of capillary hemangioma. J AAPOS 1:190

    Article  CAS  PubMed  Google Scholar 

  37. Barlow CF, Priebe CJ, Mulliken JB et al (1998) Spastic diplegia as a complication of interferon alfa-2a treatment of hemangiomas of infancy. J Pediatr 132:527–530

    Article  CAS  PubMed  Google Scholar 

  38. Denoyelle F, Leboulanger N, Enjolras O et al (2009) Role of propranolol in the therapeutic strategy of infantile laryngotracheal hemangioma. Int J Pediatr Otorhinolaryngol 73:1168–1172

    Article  PubMed  Google Scholar 

  39. Bertrand J, McCuaig C, Dubois J et al (2011) Propranolol versus prednisone in the treatment of infantile hemangiomas: a retrospective comparative study. Pediatr Dermatol 28:649–654

    Article  PubMed  Google Scholar 

  40. Price CJ, Lattouf C, Baum B et al (2011) Propranolol vs. corticosteroids for infantile hemangiomas: a multicenter retrospective analysis. Arch Dermatol 147:1371–1376

    Article  CAS  PubMed  Google Scholar 

  41. Malik MA, Menon P, Rao KL et al (2013) Effect of propranolol vs. prednisolone vs. propranolol with prednisolone in the management of infantile hemangioma: a randomized controlled study. J Pediatr Surg 48:2453–2459

    Article  PubMed  Google Scholar 

  42. Marqueling AL, Oza V, Frieden IJ et al (2013) Propranolol and infantile hemangiomas four years later: a systematic review. Pediatr Dermatol 30:182–191

    Article  PubMed  Google Scholar 

  43. Lou Y, Peng WJ, Cao Y et al (2014) The effectiveness of propranolol in treating infantile haemangiomas: a meta-analysis including 35 studies. Br J Clin Pharmacol 78:44–57

    Article  CAS  PubMed  Google Scholar 

  44. Drolet BA, Frommelt PC, Chamlin SL et al (2013) Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics 131:128–140

    Article  PubMed  PubMed Central  Google Scholar 

  45. Connelly EA, Viera M, Price C et al (2009) Segmental hemangioma of infancy complicated by life-threatening arterial bleed. Pediatr Dermatol 26:469–472

    Article  PubMed  Google Scholar 

  46. Sato Y, Frey EE, Wicklund B et al (1987) Embolization therapy in the management of infantile hemangioma with Kasabach Merritt syndrome. Pediatr Radiol 17:503–504

    Article  CAS  PubMed  Google Scholar 

  47. Fassih M, Taali L, Abada A et al (2012) Vascular tumors of the nasal cavities: a retrospective study of 10 cases. Rev Laryngol Otol Rhinol 133:87–92

    CAS  Google Scholar 

  48. Manunza F, Syed S, Laguda B et al (2010) Propranolol for complicated infantile haemangiomas: a case series of 30 infants. Br J Dermatol 162:466–468

    Article  CAS  PubMed  Google Scholar 

  49. Sans V, de la Roque ED, Berge J et al (2009) Propranolol for severe infantile hemangiomas: follow-up report. Pediatrics 124:e423–e431

    Article  PubMed  Google Scholar 

  50. Vercellino N, Romanini MV, Pelegrini M et al (2013) The use of propranolol for complicated infantile hemangiomas. Int J Dermatol 52:1140–1146

    Article  CAS  PubMed  Google Scholar 

  51. Sadykov RR, Podmelle F, Sadykov RA et al (2013) Use of propranolol for the treatment infantile hemangiomas in the maxillofacial region. Int J Oral Maxillofac Surg 42:863–867

    Article  CAS  PubMed  Google Scholar 

  52. Ben-Amitai D, Halachmi S, Zvulunov A et al (2012) Hemangiomas of the nasal tip treated with propranolol. Dermatology 225:371–375

    Article  CAS  PubMed  Google Scholar 

  53. Al Dosari S, Riad H (2013) Ulcerated nasal infantile haemangioma treated by oral propranolol. Dermatol Online J 19:18298

    PubMed  Google Scholar 

  54. Snir M, Reich U, Siegel R et al (2011) Refractive and structural changes in infantile periocular capillary haemangioma treated with propranolol. Eye 25:1627–1634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Saint-Jean M, Leaute-Labreze C, Mazereeuw-Hautier J et al (2011) Propranolol for treatment of ulcerated infantile hemangiomas. J Am Acad Dermatol 64:827–832

    Article  CAS  PubMed  Google Scholar 

  56. Hermans DJ, van Beynum IM, Schultze Kool LJ et al (2011) Propranolol, a very promising treatment for ulceration in infantile hemangiomas: a study of 20 cases with matched historical controls. J Am Acad Dermatol 64:833–838

    Article  CAS  PubMed  Google Scholar 

  57. Goswamy J, Aggarwal R, Bruce IA et al (2013) Kasabach-Merritt syndrome in a child with upper airway compromise and spontaneous periorbital bruising. Ear Nose Throat J 92, E16

    PubMed  Google Scholar 

  58. Yoon K, Lee YJ, Park DW et al (2013) Transarterial embolization of a cervicofacial hemangioma associated with Kasabach-Merritt syndrome in a premature neonate. J Vasc Interv Radiol 24:1934–1936

    Article  PubMed  Google Scholar 

  59. Buckmiller L, Dyamenahalli U, Richter GT (2009) Propranolol for airway hemangiomas: case report of novel treatment. Laryngoscope 119:2051–2054

    Article  PubMed  Google Scholar 

  60. Fellows KE, Hoffer FA, Markowitz RI et al (1991) Multiple collaterals to hepatic infantile hemangioendotheliomas and arteriovenous malformations: effect on embolization. Radiology 181:813–818

    Article  CAS  PubMed  Google Scholar 

  61. Truong MT, Perkins JA, Messner AH et al (2010) Propranolol for the treatment of airway hemangiomas: a case series and treatment algorithm. Int J Pediatr Otorhinolaryngol 74:1043–1048

    Article  PubMed  Google Scholar 

  62. Christison-Lagay ER, Burrows PE, Alomari A et al (2007) Hepatic hemangiomas: subtype classification and development of a clinical practice algorithm and registry. J Pediatr Surg 42:62–67

    Article  PubMed  Google Scholar 

  63. Beltramello A, Benati A, Perini S et al (1989) Interventional angiography in neuropediatrics. Childs Nerv Syst 5:87–93

    Article  CAS  PubMed  Google Scholar 

  64. Vildy S, Macher J, Abasq-Thomas C et al (2015) Life-threatening hemorrhaging in neonatal ulcerated congenital hemangioma: two case reports. JAMA Dermatol 151:422–425

    Article  PubMed  Google Scholar 

  65. Enomoto Y, Yoshimura S, Egashira Y et al (2011) Transarterial embolization for cervical hemangioma associated with Kasabach-Merritt syndrome. Neurol Med Chir 51:375–378

    Article  Google Scholar 

  66. Liu XJ, Qin ZP, Tai MZ (2009) Angiographic classification and sclerotic therapy of maxillofacial cavernous haemangiomas: a report of 204 cases. J Int Med Res 37:1285–1292

    Article  PubMed  Google Scholar 

  67. Stanley P, Grinnell VS, Stanton RE et al (1983) Therapeutic embolization of infantile hepatic hemangioma with polyvinyl alcohol. AJR Am J Roentgenol 141:1047–1051

    Article  CAS  PubMed  Google Scholar 

  68. Stier MF, Glick SA, Hirsch RJ (2008) Laser treatment of pediatric vascular lesions: port wine stains and hemangiomas. J Am Acad Dermatol 58:261–285

    Article  PubMed  Google Scholar 

  69. Landthaler M, Hohenleutner U, El-Raheem TA (1995) Laser therapy of childhood haemangiomas. Br J Dermatol 133:275–281

    Article  CAS  PubMed  Google Scholar 

  70. Raulin C, Greve B (2001) Retrospective clinical comparison of hemangioma treatment by flashlamp-pumped (585 nm) and frequency-doubled Nd:YAG (532 nm) lasers. Lasers Surg Med 28:40–43

    Article  CAS  PubMed  Google Scholar 

  71. David LR, Malek MM, Argenta LC (2003) Efficacy of pulse dye laser therapy for the treatment of ulcerated haemangiomas: a review of 78 patients. Br J Plast Surg 56:317–327

    Article  PubMed  Google Scholar 

  72. Hohenleutner S, Badur-Ganter E, Landthaler M et al (2001) Long-term results in the treatment of childhood hemangioma with the flashlamp-pumped pulsed dye laser: an evaluation of 617 cases. Lasers Surg Med 28:273–277

    Article  CAS  PubMed  Google Scholar 

  73. Witman PM, Wagner AM, Scherer K et al (2006) Complications following pulsed dye laser treatment of superficial hemangiomas. Lasers Surg Med 38:116–123

    Article  PubMed  Google Scholar 

  74. Michel JL (2003) Treatment of hemangiomas with 595 nm pulsed dye laser dermobeam. Eur J Dermatol 13:136–141

    PubMed  Google Scholar 

  75. Burstein FD, Williams JK, Schwentker AR et al (2006) Intralesional laser therapy treatment for hemangiomas: technical evolution. J Craniofac Surg 17:756–760

    Article  PubMed  Google Scholar 

  76. McCuaig CC, Cohen L, Powell J et al (2013) Therapy of ulcerated hemangiomas. J Cutan Med Surg 17:233–242

    Article  CAS  PubMed  Google Scholar 

  77. Macarthur CJ (2006) Head and neck hemangiomas of infancy. Curr Opin Otolaryngol Head Neck Surg 14:397–405

    Article  PubMed  Google Scholar 

  78. Mendiratta V, Varghese B, Chander R et al (2013) Successful management of airway hemangioma with propranolol. Int J Dermatol 52:750–752

    Article  PubMed  Google Scholar 

  79. Anderson de Moreno LC, Matt BH, Montgomery G et al (2013) Propranolol in the treatment of upper airway hemangiomas. Ear Nose Throat J 92:209–214

    PubMed  Google Scholar 

  80. Broeks IJ, Hermans DJ, Dassel AC et al (2013) Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature. Int J Pediatr Otorhinolaryngol 77:1791–1800

    Article  PubMed  Google Scholar 

  81. Rosbe KW, Suh KY, Meyer AK et al (2010) Propranolol in the management of airway infantile hemangiomas. Arch Otolaryngol Head Neck Surg 136:658–665

    Article  PubMed  Google Scholar 

  82. Metry D, Frieden IJ, Hess C et al (2013) Propranolol use in PHACE syndrome with cervical and intracranial arterial anomalies: collective experience in 32 infants. Pediatr Dermatol 30:71–89

    Article  PubMed  Google Scholar 

  83. Metry DW, Haggstrom AN, Drolet BA et al (2006) A prospective study of PHACE syndrome in infantile hemangiomas: demographic features, clinical findings, and complications. Am J Med Genet A 140:975–986

    Article  CAS  PubMed  Google Scholar 

  84. Vlastarakos PV, Papacharalampous GX, Chrysostomou M et al (2012) Propranolol is an effective treatment for airway haemangiomas: a critical analysis and meta-analysis of published interventional studies. Acta Otorhinolaryngol Ital 32:213–221

    CAS  PubMed  PubMed Central  Google Scholar 

  85. Hernandez-Martin S, Lopez-Gutierrez JC, Lopez-Fernandez S et al (2012) Brain perfusion SPECT in patients with PHACES syndrome under propranolol treatment. Eur J Pediatr Surg 22:54–59

    Article  CAS  PubMed  Google Scholar 

  86. Peridis S, Pilgrim G, Athanasopoulos I et al (2011) A meta-analysis on the effectiveness of propranolol for the treatment of infantile airway haemangiomas. Int J Pediatr Otorhinolaryngol 75:455–460

    Article  PubMed  Google Scholar 

  87. Komiyama M, Nakajima H, Kitano S et al (2000) Endovascular treatment of huge cervicofacial hemangioma complicated by Kasabach-Merritt syndrome. Pediatr Neurosurg 33:26–30

    Article  CAS  PubMed  Google Scholar 

  88. Zhou JX, Huang JW, Wu H et al (2013) Successful liver resection in a giant hemangioma with intestinal obstruction after embolization. World J Gastroenterol 19:2974–2978

    PubMed  PubMed Central  Google Scholar 

  89. Dickie B, Dasgupta R, Nair R et al (2009) Spectrum of hepatic hemangiomas: management and outcome. J Pediatr Surg 44:125–133

    Article  PubMed  Google Scholar 

  90. Mo JQ, Dimashkieh HH, Bove KE (2004) GLUT1 endothelial reactivity distinguishes hepatic infantile hemangioma from congenital hepatic vascular malformation with associated capillary proliferation. Hum Pathol 35:200–209

    Article  CAS  PubMed  Google Scholar 

  91. Hogeling M, Adams S, Wargon O (2011) A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics 128:e259–e266

    Article  PubMed  Google Scholar 

  92. Bagazgoitia L, Torrelo A, Gutierrez JC et al (2011) Propranolol for infantile hemangiomas. Pediatr Dermatol 28:108–114

    Article  PubMed  Google Scholar 

  93. Schupp CJ, Kleber JB, Gunther P et al (2011) Propranolol therapy in 55 infants with infantile hemangioma: dosage, duration, adverse effects, and outcome. Pediatr Dermatol 28:640–644

    Article  PubMed  Google Scholar 

  94. Bertrand J, Sammour R, McCuaig C et al (2012) Propranolol in the treatment of problematic infantile hemangioma: review of 35 consecutive patients from a vascular anomalies clinic. J Cutan Med Surg 16:317–323

    CAS  PubMed  Google Scholar 

  95. Holmes WJ, Mishra A, Gorst C et al (2011) Propranolol as first-line treatment for rapidly proliferating infantile haemangiomas. J Plast Reconstr Aesthet Surg 64:445–451

    Article  CAS  PubMed  Google Scholar 

  96. Buckmiller LM, Munson PD, Dyamenahalli U et al (2010) Propranolol for infantile hemangiomas: early experience at a tertiary vascular anomalies center. Laryngoscope 120:676–681

    Article  CAS  PubMed  Google Scholar 

  97. Shah S, Frieden IJ (2013) Treatment of infantile hemangiomas with beta-blockers: a review. Skin Therapy Lett 18:5–7

    PubMed  Google Scholar 

  98. Eivazi B, Cremer HJ, Mangold C et al (2011) Hemangiomas of the nasal tip: an approach to a therapeutic challenge. Int J Pediatr Otorhinolaryngol 75:368–375

    Article  CAS  PubMed  Google Scholar 

  99. Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J et al (2015) A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med 372:735–746

    Article  PubMed  CAS  Google Scholar 

  100. Perkins JA, Chen BS, Saltzman B et al (2014) Propranolol therapy for reducing the number of nasal infantile hemangioma invasive procedures. JAMA Otolaryngol Head Neck Surg 140:220–227

    Article  PubMed  Google Scholar 

  101. Kim LH, Hogeling M, Wargon O et al (2011) Propranolol: useful therapeutic agent for the treatment of ulcerated infantile hemangiomas. J Pediatr Surg 46:759–763

    Article  PubMed  Google Scholar 

  102. Yeh I, Bruckner AL, Sanchez R et al (2011) Diffuse infantile hepatic hemangiomas: a report of four cases successfully managed with medical therapy. Pediatr Dermatol 28:267–275

    Article  PubMed  Google Scholar 

  103. Mazereeuw-Hautier J, Hoeger PH, Benlahrech S et al (2010) Efficacy of propranolol in hepatic infantile hemangiomas with diffuse neonatal hemangiomatosis. J Pediatr 157:340–342

    Article  PubMed  Google Scholar 

  104. Brauer JA, Geronemus RG (2013) Laser treatment in the management of infantile hemangiomas and capillary vascular malformations. Tech Vasc Interv Radiol 16:51–54

    Article  PubMed  Google Scholar 

  105. McHugh K, Burrows PE (1992) Infantile hepatic hemangioendotheliomas: significance of portal venous and systemic collateral arterial supply. J Vasc Interv Radiol 3:337–344

    Article  CAS  PubMed  Google Scholar 

  106. Seo HI, Jo HJ, Sim MS et al (2009) Right trisegmentectomy with thoracoabdominal approach after transarterial embolization for giant hepatic hemangioma. World J Gastroenterol 15:3437–3439

    Article  PubMed  PubMed Central  Google Scholar 

  107. Jangjoo A, Mehrabi Bahar M, Aliakbarian M (2010) Ruptured giant hepatic hemangioma: report of a case. Acta Med Iran 48:419–422

    PubMed  Google Scholar 

  108. Kayan M, Cetin M, Aktas AR et al (2012) Pre-operative arterial embolization of symptomatic giant hemangioma of the liver. Prague Med Rep 113:166–171

    Article  CAS  PubMed  Google Scholar 

  109. Lupinacci RM, Szejnfeld D, Farah JF (2011) Spontaneous rupture of a giant hepatic hemangioma. Sequential treatment with preoperative transcatheter arterial embolization and conservative hepatectomy. G Chir 32:469–472

    CAS  PubMed  Google Scholar 

  110. Akamatsu N, Sugawara Y, Komagome M et al (2010) Giant liver hemangioma resected by trisectorectomy after efficient volume reduction by transcatheter arterial embolization: a case report. J Med Case Rep 4:283

    Article  PubMed  PubMed Central  Google Scholar 

  111. Jain V, Ramachandran V, Garg R et al (2010) Spontaneous rupture of a giant hepatic hemangioma — sequential management with transcatheter arterial embolization and resection. Saudi J Gastroenterol 16:116–119

    Article  PubMed  PubMed Central  Google Scholar 

  112. Casasco A, Herbreteau D, Houdart E et al (1994) Devascularization of craniofacial tumors by percutaneous tumor puncture. AJNR Am J Neuroradiol 15:1233–1239

    CAS  PubMed  Google Scholar 

  113. Luo Q, Zhao F (2011) How to use bleomycin A5 for infantile maxillofacial haemangiomas: clinical evaluation of 82 consecutive cases. J Craniomaxillofac Surg 39:482–486

    Article  PubMed  Google Scholar 

  114. Jayakumar PN, Desai SV, Kovoor JM et al (2002) Percutaneous embolization of mandibular hemangioma: a case report. J Oral Maxillofac Surg 60:945–948

    Article  CAS  PubMed  Google Scholar 

  115. Hou J, Wang M, Tang H et al (2011) Pingyangmycin sclerotherapy for infantile hemangiomas in oral and maxillofacial regions: an evaluation of 66 consecutive patients. Int J Oral Maxillofac Surg 40:1246–1251

    Article  CAS  PubMed  Google Scholar 

  116. Smit DP, Meyer D (2012) Intralesional bleomycin for the treatment of periocular capillary hemangiomas. Indian J Ophthalmol 60:326–328

    Article  PubMed  PubMed Central  Google Scholar 

  117. Bruckner AL, Frieden IJ (2003) Hemangiomas of infancy. J Am Acad Dermatol 48:477–493

    Article  PubMed  Google Scholar 

  118. Reddy KK, Blei F, Brauer JA et al (2013) Retrospective study of the treatment of infantile hemangiomas using a combination of propranolol and pulsed dye laser. Dermatol Surg 39:923–933

    Article  CAS  PubMed  Google Scholar 

  119. Esterly NB (1996) Cutaneous hemangiomas, vascular stains and malformations, and associated syndromes. Curr Probl Pediatr 26:3–39

    CAS  PubMed  Google Scholar 

  120. Daramola OO, Chun RH, Nash JJ et al (2011) Surgical treatment of infantile hemangioma in a multidisciplinary vascular anomalies clinic. Int J Pediatr Otorhinolaryngol 75:1271–1274

    Article  PubMed  Google Scholar 

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Acknowledgments

All 3-D images are courtesy of Robyn Augustyn BSRT(R) (CT) and Marrit Thorkelson RT(R) (MR).

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Authors and Affiliations

  1. Phoenix Regional Campus, Creighton University School of Medicine, Phoenix, AZ, USA

    Deanna Menapace & Mario Mitkov

  2. Department of Otorhinolaryngology, Mayo School of Graduate Medical Education-MN, Rochester, MN, USA

    Deanna Menapace

  3. Department of Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA

    Richard Towbin

  4. Division of Dermatology, University of California, Los Angeles, 1245 16th Street, suite 204, Santa Monica, CA, 90404, USA

    Marcia Hogeling

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  1. Deanna Menapace
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  2. Mario Mitkov
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  4. Marcia Hogeling
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Correspondence to Marcia Hogeling.

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Menapace, D., Mitkov, M., Towbin, R. et al. The changing face of complicated infantile hemangioma treatment. Pediatr Radiol 46, 1494–1506 (2016). https://doi.org/10.1007/s00247-016-3643-6

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  • DOI: https://doi.org/10.1007/s00247-016-3643-6

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