Hemangioma of the radius associated with Kasabach-Merritt syndrome: case report and literature review

Abstract

The Kasabach-Merritt syndrome of consumptive coagulopathy associated with massive hemangiomas is a potentially life-threatening problem in patients with a pathologic fracture of the osseous lesion. This can result in massive bleeding even after minor trauma. In such patients, operative management of long bone hemangiomatous lesions, including percutaneous needle aspirations, may be contraindicated, and nonoperative management may be preferable. Kasabach-Merritt syndrome must be suspected in patients with large hemangiomas with associated bone lesions, and appropriate coagulation studies should be obtained before any operative management. Review of the world English literature on Kasabach-Merritt syndrome has revealed that the most common pathologic fractures occur in the vertebral bodies. An additional case report of a child with a pathologic fracture and deformity of his radius has been documented. Decreased hematocrit and fibrinogen levels associated with thrombocytopenia and a prolonged prothrombin time and partial thromboplastin time in association with bone hemangioma should alert the orthopaedist to the possibility of Kasabach-Merritt syndrome.