Infantile hemangiomas, complications and follow-up

Abstract

Objective: To study the risk factors for hemangioma-related complications, treatment indications and analyze the outcome of patients with infantile hemangioma.

Design: Retrospective.

Setting: University hospital.

Patients: Fifty-five patients (1-69 months; median: 12 months) with infantile hemangioma with mean follow-up 19 months. The eligibility was based on the criteria of the International Society for the Study of Vascular Anomalies (ISSVA).

Intervention: The surgical treatment included total excision whereas medical treatment was carried out by interferon and /or corticosteroids.

Main outcome measures: Data was collected including sex, age, prematurity, age at onset, number, anatomic location and size of hemangioma, age at treatment, cause of treatment decision, family history, presence of extra malformations, involvement of internal organs, presence of life altering or life threatening complications, response to treatment, dose and duration of medications, complications associated with treatment, follow-up period, and final outcome.

Results: Thirty-four (62%) patients were followed-up without treatment, whereas 21 others underwent treatment including steroids, interferon, and surgery. The size of hemangioma was a major factor that predicted hemangioma-related complications (P=0.002). Patients with hemangioma related complications had bigger lesions (size >40 cm² or the longest size on a single plane >5 cm). Nineteen patients (34%) had complications, but only 8 (14.5%) out of them had life or function-threatening complications.

Conclusion: Although dosing and treatment protocol is still debatable, steroids and interferon are good options for hemangioma treatment. The management strategy should be individualized for each case.