Follow up and management of childhood hemangiomas – Review

Yıl 2007, Cilt: 42 Sayı: 3, 94 - 97, 01.09.2007

Tiraje Celkan

Öz

Vascular lesions especially hemangiomas are common in infants and children They have a proliferative phase in early infancy followed by an involutional phase leading to complete spontaneous regression in most patients Involution usually begins by 1 year and continues over 4 to 6 years Only a minor cutaneous blemish will remain Fortunately most hemangiomas only grow to a small size and do not cause problems However there is a small subset of hemangiomas that destroy tissue or endanger the infant’s life either because of the tumor’s size location or aggressive growth Pediatricians must be prepared to respond to the anxious parents’ questions Pediatricians continue to play a pivotal role in the management of infantile hemangiomas They are usually the first to discover the tumor or the cutaneous marks They must see the infant frequently because it is difficult to predict the ultimate size and behavior of a particular tumor Turk Arch Ped 2007; 42: 94 7 Key words: Hemangiomas management

Anahtar Kelimeler

-

Çocukluk çağı hemanjiyomlarının izlemi ve tedavisi Derleme

Öz

Çocukluk çağında damar kaynaklı tümörlere özellikle de hemanjiyomlara sık rastlanılır Hemanjiyomlar genellikle erken süt çocuğu döneminde hızlı büyür ve çoğu olguda kendiliğinden geriler Gerileme genellikle bir yıl civarında başlar ve 4 6 yaşına dek devam eder Hafif bir leke olarak kalabilir Hemanjiyomlar genellikle sorun yaratmaz Küçük bir bölüm hemanjiyom ise doku harabiyetine yol açması boyutu yeri veya agresif büyümesi nedeni ile süt çocuğuna sorun yaratabilir Çocuk hekimleri tedirgin ebeveynlerin sorularını yanıtlayacak yetkinlikte olmalıdır Çocuk hekimleri hemanjiyomların tedavisinde önemli rol üstlenirler Çoğunlukla kitle ve lekeyi ilk fark eden çocuk hekimleridir Çocukları yakından izlemeli boyut ve davranış değişikliklerini erkenden fark etmelidir Türk Ped Arş 2007; 42: 94 7 Anahtar kelimeler: Hemanjiyom tedavi

Anahtar Kelimeler

-

Kaynakça

• Edgerton MT. The treatment of hemangiomas with special re- ference to the role of steroid therapy. Ann Surg 1976;183:517- 32.
• Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol 2003; 48: 477-93.
• Dinehart SM, Kincannon J, Geronemus R. Hemangiomas: eva- luation and treatment. Dermatol Surg 2001; 27: 475-85.
• Akyüz C, Yarış N, Kutluk MT, Büyükpamukçu M. Benign vascu- lar tumors and vascular malformations in childhood: a retros- pective analysis of 1127 cases. Turk J Pediatr 1997; 39: 435- 45.
• Yarış N, Akyüz C. Çocukluk çağı benin vasküler tümörleri ve vasküler malformasyonları. Katkı Pediatri Dergisi 1995; 16: 618- 33.
• Akyüz C, Yarış N, Kutluk MT, Büyükpamukçu M. Management of cutaneous hemangiomas: a retrospective analysis of 1109 cases and comparison of conventional dose prednisolone with high-dose methylprednisolone therapy. Pediatr Hematol Oncol 2001; 18: 47-55.
• Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983;18: 894.
• Chiller KG, Passaro D, Frieden IJ. Hemangiomas of infancy: cli- nical characteristics, morphologic subtypes, and their relations- hip to race, ethnicity, and sex. Arch Dermatolol 2002; 138: 1567-76.
• Mulliken JB, Glowacki J. Hemangiomas and vascular malfor- mations of infants and children, a classification based on en- dothelial characteristics. Plast Reconstr Surg 1982; 69: 412.
• Pasyk KA, Cherry GW, Grabb WC, Sasaki GH. Quantitative evaluation of mast cells in cellularly dynamic and adynamic vascular malformations. Plast Reconstr Surg 1984; 73: 69-75.
• Glowacki J, Mulliken JB. Mast cells in hemangiomas and vas- cular malformations. Pediatrics 1982; 70: 48-51.
• Leon-Villapalos J, Wolfe K, Kangesu L. GLUT-1: an extra diag- nostic tool to differentiate between hemangiomas and vascular malformations. Br J Plast Surg 2005; 58: 348-52.
• Boon LM, Enjolras O, Mulliken JB. Congenital hemangioma: evidence of accelerated involution. J Pediatr 1996; 128: 329- 35.
• Barlow RJ, Walker NPJ, Markey AC. Treatment of proliferative haemangiomas with the 585 nm pulsed dye laser. Br J Derma- tol 1996; 134: 700-34.
• Cohen RC, Myers NA. Diagnosis and management of hepatic hemangiomas in childhood. J Pediatr Surg 1986; 21:6.
• Enjolras O, Riche MC, Merland JJ. Management of alarming hemangiomas in infancy: a review of 25 cases. Pediatrics 1990; 85: 491-8.
• Sterker I, Grafe G. Periocular hemangiomas in childhood-func- tional and aesthetic results. Strabismus 2004; 12: 103-10.
• DuBois J, Gasel L. Imaging and the therapeutic approach of hemangiomas and vascular malformations in the pediatric age group. Pediat Radiol 1999; 29: 879-930.
• Christensen JT, Gutenberg B. Intramuscular hemangioma of the extremities: is computerized tomography useful? Br J Surg 1985; 72: 748-50.
• Memis A, Arkun R, Ustun EE. MRI of intramuscular hemangi- omas with emphasis on contrast enhancement patterns. Clin Radiol 1996; 51: 198-204.
• Ho J, Kendrick V, Deney D, Pacaud D. New insights into the pathophysiology of severe hypothyridism in ana infant with multiple hepatic hemangiomas. J Pediatr Endocrinol Metab 2005; 18: 511-4.
• Ceisler EJ, Santos L, Blei F. Periocular hemangiomas: What every physician should know. Pediatric Dermatology 2004; 21: 1–9.
• Zarem H, Edgerton M. Induced resolution of cavernous heman- gioma following prednisolone therapy. Plast Reconstr Surgery 1967; 39: 76-83.
• Bennett ML, Fleischer A, Chamlin S, Freiden IJ. Oral corticos- teroids use in effective cutaneous hemangiomas, an evidence based evaluation. Arch Derm 2001;137: 1208-13.
• Sadan N, Wolach B. Treatment of hemangiomas of infants with high doses of prednisone. J Pediatr 1996; 128: 141-6.
• Gangopadhyay AN, Sinha CK, Gopal SC, Gupta DK, Sahoo SP, Ahmad M. Role of steroid in childhood haemangioma: a 10 ye- ars review. Int Surg 1997; 82: 49-51.
• Marler JJ, Mulliken JB. Current management of hemangiomas and vascular malformations. Clin Plast Surg 2005; 32: 99-116.
• Oak SN, Viswanath Naveen. Management of hemangiomas in children. Indian Dermatol Venerol Leprol 2006; 72: 1-4.
• Pope E, Krafchik BR, Macarthur C, et al. Oral versus high dose pulse corticosteroids for problematic infantile hemangiomas, a randomized controlled trial. Pediatrics. 2007 7; [Epub ahead of print.
• Ozsolyu S. Megadose methylprednisolone therapy for Kasa- bach-Merritt. J Pediatr 1996;129: 947.
• Boon LM, MacDonald DM, Mulliken JB. Complication of syste- mic corticosteroid therapy for problematic hemangiomas. Plast Reconstr Surg 2002; 109: 1544.
• Chowdri NA, Darzi MA, Fazili Z, Iqbal S. Intralesional corticos- teroid therapy for childhood cutaneous hemangiomas. Ann Plast Surg 1994; 33: 46-51.
• Sloan GM, Reinish JF, Nichter LS, Saber WL, Lew K, Morwood DT. Intralesional corticosteroid therapy for infantile hemangi- omas. Plast Reconstr Surg 1989; 83: 459-66.
• Jain P, Sinha JK. A comparative study of some treatment mo- dalities in cutaneous haemangiomas. Indian J Plast Surg 1995; 28: 77-9.
• Muir T, Kirsten M, Fourie P, Dippenaar N, Ionescu GO. Intrale- sional bleomycin injection (IBI) treatment for haemangiomas and congenital vascular malformations. Pediatr Surg Intl 2004;19: 766-73.
• Schrudde J, Petrovici V. Surgical treatment of giant hemangi- oma of the facial region after arterial embolization. Plast Re- constr Surg 1981; 68: 878-88.
• Stringel G, Mercer S. Giant hemangioma in the newborn and in- fants. Clin Pediatr 1984; 23: 498-502.
• Stringel G. Giant hemangioma: treatment with intermittent pne- umatic compression. J Ped Surg 1987; 22: 7-10.
• Soumekh B, Adams G, Shapiro R. Treatment of head and neck hemangiomas with recombinant Interferon alpha 2b. Ann Oto Rhinol Laryngo 1996; 105: 201-6.
• Grienwald J, Burle D, Bontheus D. An update on treatment of hemangiomas in children with Interferon alpha-2a. Arch Oto- laryngology H&N Surg 1999; 125: 27.
• Brouty-Boyce D, Zetter BR. Inhibition of cell motility by Interfe- ron. Science 1980; 208: 516-8.
• Batta K, Goodyear H, Moss C. Ramdomized controlled study of early pulse dye laser treatment of uncomplicated childhood hemangiomas: results of a one year analysis. Lancet 2002; 360: 521-7.
• Hurwitz DJ, Kerber CW. Hemodynamic considerations in the treatment of arteriovenous malformations in the face and scalp. Plast Reconstr Surg 1981; 67: 421-32.
• Sterescu AE, Rousseau-Harsany E, Farrell C, Powell J, David M, Dubois J. The potential efficacy of 3 fatty acids as anti-an- giogenic agents in benign vascular tumors of infancy. Medical Hypotheses, 2006; 66: 1121–4.