Craniofacial cavernous hemangioma: Succesful treatment with methylprednisolone

Department of Dermatology and Venereology, Medical University of Sofia, 1 St. George Sofiiskyi Str., 1431 Sofia, Bulgaria.
Acta dermatovenerologica Alpina, Panonica, et Adriatica 07/2005; 14(2):49-52.
Source: PubMed


Systemic corticosteroid treatment is reported as effective for problematic cutaneous hemangiomas occuring in infancy, and depend on the dose, the duration of treatment, and the age at which the course of drugs is initiated. A 7-month-old female infant with extended cavernous hemangioma on the left part of forehead, face,and neck which appeared 15 days after birth is presented. She was successfully treated with oral methylprednisolone (initial doses of 3 mg/kg/daily and reduced in steps over 6 months) with significant involution of the lesions and with good aesthetic results. The oral corticosteroid treatment is an efficient medical therapy for common extended cavernous infantile hemangiomas with accelerated growth if initiated early in the proliferative phase.

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Available from: Lyubomir Dourmishev, Oct 04, 2015
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    • "Nevertheless, the treatment options include surgical and non-surgical methods. Systemic steroid therapy may be indicated in IH and the reported success is documented [10,11]. Corticosteroid treatment, although recognized worldwide as a treatment of problematic haemangiomas cannot always control the growth of alarming haemangiomas [12]. "
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    ABSTRACT: Infantile haemangioma is the commonest benign tumour in infancy. While the management of the majority of small haemangiomas consists of simply watching or steroid treatment, giant and moderate size infantile haemangiomas are challenging problems, especially in health systems with limited resources in developing countries. A one-year old boy was presented to us by his parents with a moderate size haemangioma on the posterior triangle of the left side of the neck. Clinical assessment and radiological examinations were helpful in confirming the diagnosis. Surgical excision was performed successfully without major morbidity. Partial necrosis of the skin flap developed shortly after the operation but healing was complete in eight weeks. There was no residual problem on review five years after the operation. Early surgical excision of a moderate size infantile haemangioma may be justified especially when there is difficulty of follow-up, which can be a common problem in developing countries. This approach will prevent growth deformation, impact on nearby vital organs and psychological problems.
    Journal of Medical Case Reports 02/2008; 2:52. DOI:10.1186/1752-1947-2-52
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    ABSTRACT: Vascular lesions of the oral cavity represent a diagnostic challenge for clinicians. Beyond the need to separate hemangioma and other tumors from malformations, it is evident that over the years the term hemangioma was overapplied without regard to etiology or clinical behaviour (reviewed in ref. 1). The misunderstanding on the nosologic distinction between oral haemangiomas and vascular malformations still leads to diagnostic mistakes. Despite the International Society for the Study of Vascular Anomalies (ISSVA) adopted a biology-based classification system, the term haemangioma continues to be o verused by clinicians. By presenting a case of multiple oral vascular tumescence of uncertain origin, here we sought to briefly address this controversy. Case Presentation A 36-year-old male was referred to the surgery service of the Second University of Naples complaining difficulties in eating. On clinical examination, he exhibited a swelling in left parotid region (Fig.1). It was present since childhood but was increased in volume in the last 15 years. This lesion was completely asymptomatic and covered by apparently uninflamed skin without any discoloration. The tumescence was dislocable from underlying layers, fluctuating and reducible. No internal pulsations were detectable. Head and neck lymph nodes were painless, not palpable, and there was no clinically detectable lymphadenopathy. Patient didn't refer any subjective symptomatology. However, he reported an increase of the swelling both in the morning after awakening and in supine position. The enlarged tumescence paralleled with changes in its consistency, probably due to t he augmented blood afflux to the vascular channels composing the tumour. Intraoral examination revealed the p resence of three vascular lesions situated on both left margin and ventral side of the tongue (Fig.2). The lesion located in the third posterior of the tongue on its left margin (Fig.2a, 2b) appeared ten years ago as a little prominence which underwent a slow but progressive growth. At present the tumour measured about 1.5 cm in diameter. Within the subsequent six years two more tumescence appeared. One was on the left margin of the tongue (Fig. 2c) and the second one on its ventral side (Fig. 2d). Both had i ncreased in volume in the last ten years. These tongue vascular anomalies presented many similar clinical features: they were exophytic and irregularly spherical in shape, painless, variable in diameter (1 cm to 2 cm), covered by red to r ed-blue-violet mucosa. The patient referred trouble in chewing and eating, along with pain and bleeding during mastication. Color doppler imaging was suggestive of mixed arteriovenous vascular lesions (not shown). A clinical diagnosis of vascular tumour was established, which was compatible with both vascular malformation and vascular neoplasm (haemangioma). The patient was operated in total anaesthesia and electroscalpel was preferred to prevent bleeding. Suture was made in absorbable material for muscular tissues and silk for superficial tissues.
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    ABSTRACT: Nasal tip hemangiomas cause significant parental distress and can negatively affect the psychological development of a child. Treatment is controversial, with numerous modalities available for reconstruction. The authors outline their combined medical and surgical approach to treating nasal tip hemangiomas and describe their preferred surgical technique. A retrospective review was performed of all nasal tip hemangiomas presenting to the Multidisciplinary Vascular Anomalies Clinics at the Children's Hospital of Wisconsin and Children's Hospital of Michigan from 1999 to 2007. Parameters for review included onset age, symptoms, medical therapies (laser with or without steroid) used, age and status of lesion at time of surgery, outcomes, and complications. Twenty-five patients met inclusion criteria, with a mean onset age of 1.43 months. Most received steroids and pulsed dye laser therapy (mean no. of laser treatments, 3.5) during the proliferative and plateau phases of the tumor's natural history. Surgical resection after involution has been performed using an open rhinoplasty technique on 15 patients thus far. Eleven of them had surgical correction in the postinvolutional phase, and at parental request, four had early surgical correction during the proliferative-plateau phases. In the early treatment cohort, one child developed a hematoma postoperatively; the same patient required a revision rhinoplasty for alar rim asymmetry. Acceptable aesthetic results were obtained in both groups. A combined medical and surgical approach offers the best method to treat the Cyrano nose. The authors' treatment algorithm uses early medical management to accelerate involution of the lesion, providing optimal conditions for excision. Early surgical treatment also allows satisfactory results but may require secondary correction. An open rhinoplasty approach with skin resection is the authors' preferred technique.
    Plastic and Reconstructive Surgery 10/2010; 126(4):1291-9. DOI:10.1097/PRS.0b013e3181ea44c5 · 2.99 Impact Factor
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