Subscribe to RSS
DOI: 10.1055/s-0036-1581083
Successful Propranolol Treatment of Multiple Infantile Hemangiomas with Predominant Neuroaxial Involvement: a Case Report
Hemangioma múltiplo da infância com envolvimento predominantemente neuroaxial tratado com propranolol: relato de casoPublication History
09 November 2015
19 January 2016
Publication Date:
14 April 2016 (online)
Abstract
Infantile hemangiomas (IH) are the most common vascular tumor of infancy. Occurrences during the neonatal period are divided in multiple congenital, limited to skin involvement, or diffuse neonatal hemangiomatosis (DNH). DNH is considered to be a benign and rare disease, determined by the presence of multiple cutaneous and extracutaneous hemangiomas. The encephalic and medullary involvement of IHs is unusual and rarely reported. The authors report a case of infantile hemangioma (IH) as diffuse neonatal hemangiomatosis with predominant central nervous system involvement on a neonate, treated with propranolol. We discuss the use propranolol as main therapy and review the available data regarding IHs with neuroaxial involvement and its treatment.
Resumo
Hemangiomas da infância (HI) são o tipo mais comum de tumores vasculares nessa faixa etária, e, quando no período neonatal, podem ser divididos em múltiplos congênitos, limitados ao envolvimento cutâneo, ou hemangiomatose neonatal difusa (HND). A HND é considerada uma doença rara e benigna, determinada pela presença de múltiplos hemangiomas cutâneos e extracutâneos. O envolvimento encefálico e medular nos HI é incomum e raramente reportado. Relatamos um caso de hemangioma da infância na forma de hemangiomatose neonatal difusa com acometimento predominante do sistema nervoso central tratado com propranolol em neonato. São discutidos o uso de propranolol como terapia de escolha e a revisão de literatura sobre HI com envolvimento neuroaxial e sua terapêutica.
-
References
- 1 Gontijo B, Silva CMR, Pereira LB. Hemangioma da infância. An Bras Dermatol 2003; 78 (6) 651-673
- 2 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69 (3) 412-422
- 3 Maya J. Gerardo Blanco, Rocío Maldonado. Diffuse neonatal hemangiomatosis. Bol Med Hosp Infant Mex 2013; 70 (1) 35-40
- 4 Viswanathan V, Smith ER, Mulliken JB , et al. Infantile hemangiomas involving the neuraxis: clinical and imaging findings. AJNR Am J Neuroradiol 2009; 30 (5) 1005-1013
- 5 Al-Kaabi A, Yanofsky R, Bunge M, Hyman J, Rafay MF. Diffuse hemangiomatosis with predominant central nervous system involvement. Pediatr Neurol 2009; 40 (1) 54-57
- 6 Liu X, Qu X, Zheng J, Zhang L. Effectiveness and Safety of Oral Propranolol versus Other Treatments for Infantile Hemangiomas: A Meta-Analysis. PLoS ONE 2015; 10 (9) e0138100
- 7 Bonini FK, Bellodi FS, Souza EM. Propranolol treatment for hemangioma of infancy. An Bras Dermatol 2011; 86 (4) 763-766
- 8 Metry DW, Hebert AA. Benign cutaneous vascular tumors of infancy: when to worry, what to do. Arch Dermatol 2000; 136 (7) 905-914
- 9 Albiñana V, Villar Gómez de Las Heras K, Serrano-Heras G , et al. Propranolol reduces viability and induces apoptosis in hemangioblastoma cells from von Hippel-Lindau patients. Orphanet J Rare Dis 2015; 10 (1) 1-12
- 10 Patiroglu T, Sarici D, Unal E , et al. Cerebellar hemangioblastoma associated with diffuse neonatal hemangiomatosis in an infant. Childs Nerv Syst 2012; 28 (10) 1801-1805
- 11 Drolet BA, Frommelt PC, Chamlin SL , et al. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics 2013; 131 (1) 128-140
- 12 Broeks IJ, Hermans DJJ, Dassel ACM, van der Vleuten CJM, van Beynum IM. Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature. Int J Pediatr Otorhinolaryngol 2013; 77 (11) 1791-1800
- 13 Zvulunov A, McCuaig C, Frieden IJ , et al. Oral propranolol therapy for infantile hemangiomas beyond the proliferation phase: a multicenter retrospective study. Pediatr Dermatol 2011; 28 (2) 94-98
- 14 Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo J-B, Taïeb A. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008; 358 (24) 2649-2651
- 15 Xiao Q, Li Q, Zhang B, Yu W. Propranolol therapy of infantile hemangiomas: efficacy, adverse effects, and recurrence. Pediatr Surg Int 2013; 29 (6) 575-581
- 16 Peridis S, Pilgrim G, Athanasopoulos I, Parpounas K. A meta-analysis on the effectiveness of propranolol for the treatment of infantile airway haemangiomas. Int J Pediatr Otorhinolaryngol 2011; 75 (4) 455-460
- 17 Hogeling M, Adams S, Wargon O. A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics 2011; 128 (2) e259-e266
- 18 Sans V, de la Roque ED, Berge J , et al. Propranolol for severe infantile hemangiomas: follow-up report. Pediatrics 2009; 124 (3) e423-e431
- 19 Miquel J, Bruneau B, Dupuy A. Successful treatment of multifocal intracerebral and spinal hemangiomas with propranolol. J Am Acad Dermatol 2014; 70 (4) e83-e84
- 20 Langley A, Pope E. Propranolol and central nervous system function: potential implications for paediatric patients with infantile haemangiomas. Br J Dermatol 2015; 172 (1) 13-23