Infantile Subglottic Hemangioma: A Case Report

Introduction The rare nature of Infantile Subglottic Hemangiomas and the absence of huge comparative studies and diagnostic or therapeutic guidelines can make an evaluation challenging. The chance of quickly developing, possibly life-threatening complications by airway obstruction makes a precise diagnosis and a solid consideration of all available treatment options important.

Materials and Methods A three moths old girl with a reported history of biphasic stridor and periodic respiratory distress was admitted to the pediatric ward. Long phases of normal breathing would alter with sudden intervals of severe dyspnea. Initial treatment with steroids would temporarily reduce the symptoms. Bronchoscopy revealed a large reddish mass at the posterior tracheal wall in left sided subglottic position. The diagnosis was confirmed by contrast-enhanced CT and excluded other localizations. A closely monitored treatment with a Beta blocker was initiated (from 1mg/kg for 24h to 3mg/kg for 24h at discharge). No side effects have been observed.

Results Significant respiratory improvement could be observed after 48 hours. The girl was discharged from the ward one week after the start of treatment with no further respiratory symptoms. Follow up endoscopy after 6 weeks revealed a significant reduction of the lesion (>50 %).

Conclusion The multilevel diagnostic and therapeutic approach has shown to be beneficial. Combination of bronchoscopy and contrast enhanced CT enable a solid diagnosis. The Beta blocker treatment has shown to be effective. Close monitoring will ensure the accuracy of the chosen therapy.

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Publication History

Article published online:
10 June 2020