Pediatria pre prax 2/2021

Interesting case reports on treating haemangiomas from clinical practice

Infantile haemangiomas (IH) are the most common benign tumours in children. Approximately 90% of IH regress spontaneously over the years, but a relatively high proportion leave a cosmetically disturbing residuum in the form of fibro-fatty tissue, scarring, atrophy, or residual telangiectasias (2). Subsequently, children with a more serious residuum are referred for treatment late, i.e. in the phase of involution, when the residuum can no longer be managed with systemic propranolol, with the only options left being surgical correction or laser treatment. IH that are often underrated include smaller haemangiomas located particularly in the central facial area, forehead, ears, and neck, for which the chance of leaving a cosmetically disturbing residuum is as high as 50% (1, 2), as well as those in which there is a risk of ulceration, e.g. IH in the nappy area, neck folds, lower lip, etc. (1). The article presents three case reports of children with more complicated IH requiring long-term treatment with systemic propranolol. The first case is a child with a deep haemangioma on the upper eyelid in whom magnetic resonance imaging of the orbit and CNS was required prior to treatment initiation. The second case reports a child with a segmental-type haemangioma on the forearm in whom treatment was temporarily discontinued due to a condition of collapse of unclear aetiology. In the third case, the parents refused the treatment of perianal haemangioma initially; however later on, due to further haemangioma growth and ulceration formation, they agreed to treatment.

Keywords: infantile hemangioma, propranolol