Infantile hemangioma-mechanism(s) of drug action on a vascular tumor

Abstract

Infantile hemangioma (IH), a benign vascular tumor, is the most common tumor of infancy, with an incidence of 5%-10% at the end of the first year. The tumor displays a distinctive life cycle consisting of a proliferating phase, occurring in the first months of life, followed by an involuting phase. Thus, IH represents a unique model of postnatal vasculogenesis, angiogenesis, and vessel regression. Traditionally, corticosteroids were the drug of choice when treatment of IH was indicated. In recent years, beta-blockers, most specifically propranolol, have serendipitously been shown to be an effective pharmacological treatment. This article will focus on the mechanism of action of these two drugs, the old and the new treatments, in slowing the growth and accelerating involution of IH.

Figure 1.

Proliferating, involuting, and involuted phases of infantile hemangioma. Hematoxylin and eosin stain (H&E) stained sections from each phase. (A) Proliferating phase is highly cellular with immature vessels, (B) involuting phase contains well-formed blood vessels with endothelial and perivascular layers, and (C) involuted phase contains adipocytes, fibrous deposits, and few remaining vessels. Scale bar, 100 µm.