Clinical and radiological characteristics of patients with retroperitoneal infantile hemangiomas

Background Infantile hemangiomas (IHs) are the most common tumors of infancy. The objective was to identify clinical and radiological patterns in patients with retroperitoneal IHs. Methods We reviewed patients from our Vascular Anomalies Center database with IHs and abdominal imaging presenting from...

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Published in:Pediatric dermatology 2019-11, Vol.36 (6), p.823-829
Main Authors: Peterman, Caitlin M., Gibson, Ruby S., Lillis, Anna P., Fishman, Steven J., Liang, Marilyn G.
Format: Article
Language:English
Subjects:
Adrenal glands
Anorectal
Aorta
Corticosteroids
Duodenum
Dyspnea
Fatal Outcome
Female
Hemangioma
Hemangioma - diagnostic imaging
Hemangioma - therapy
Humans
Infant
Infant, Newborn
infantile hemangioma
Large intestine
Male
Pancreas
Patients
Propranolol
Respiration
retroperitoneal
Retroperitoneal Neoplasms - diagnostic imaging
Retroperitoneal Neoplasms - therapy
Sacrum
Skin Neoplasms - diagnostic imaging
Skin Neoplasms - therapy
Small intestine
Tumors
vascular anomaly
Vincristine
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Summary:Background Infantile hemangiomas (IHs) are the most common tumors of infancy. The objective was to identify clinical and radiological patterns in patients with retroperitoneal IHs. Methods We reviewed patients from our Vascular Anomalies Center database with IHs and abdominal imaging presenting from 1999 to 2017 to identify retroperitoneal involvement. Results Eleven patients (10 females, one male) with retroperitoneal IHs were found. Cutaneous IHs were present in eight patients (five segmental (45%), three multifocal (27%)) and absent in 1 (9%). Segmental hemangiomas involved the face in 2/5 (40%) and lower body in 3/5 (60%). The most common symptoms were dyspnea (n = 4), hematochezia (n = 3), and/or ulceration (n = 2). Three patients were asymptomatic. Involved retroperitoneal organs included the duodenum (n = 4), pancreas (n = 3), and adrenal glands (n = 1). Non‐retroperitoneal organ involvement included the liver (n = 5), non‐duodenal small intestine (n = 4), and large intestine (n = 3). Perivascular retroperitoneal hemangiomas were seen in 6/11 patients (55%), most commonly surrounding the aorta (n = 5), iliac vessels (n = 2), and/or inferior vena cava (n = 2). Three of 11 patients (27%) had LUMBAR based on a segmental, sacral hemangioma with tethered cord or anorectal malformation. Follow‐up information was available in 6/11 patients (55%): 5 symptomatically improved with treatment (propranolol, corticosteroids, and/or vincristine), while one succumbed from extensive hepatic involvement. Conclusion Retroperitoneal IHs are rare and tend to involve organs or surround vessels. Associated cutaneous IHs, if present, lack anatomical predilection and may be segmental or multifocal.
ISSN:0736-8046
1525-1470
DOI:10.1111/pde.13982