The number of systematic reviews published in the urology literature has exponentially increased, year by year, but their methodological quality has stagnated. To enhance the validity and impact of systematic reviews, all authors and editors must apply established methodological standards.

Congenital hemangiomas (CH) are rare vascular tumors of the neonate, with an estimated incidence of less than 0.5%. 1 CH are present at birth and may involute to varying degrees over the first 2-12 months of age. 2 Based on the course and degree of involution, CH are subdivided into rapidly, partially, and non-involuting subtypes. [3][4][5] Complications of CH are rare and primarily related to high-flow vasculature that may initially be present before the involution phase begins. The most common sequela of this includes ulceration and bleeding, particularly in the peripartum period. 6,7 High-output congestive heart failure can rarely result from intralesional shunting in larger CH, particularly those within visceral organs. Increased blood flow can also lead to a mild coagulopathy, evidenced by hypofibrinogenemia and thrombocytopenia. 2,[8][9][10][11] These findings are usually transient and less severe than Kasabach-Merritt phenomenon (KMP), which occurs most commonly in patients with kaposiform hemangioendotheliomas (KHE) and less so with tufted angiomas (TA). 12 Typically, CH can be managed supportively and expectantly.However, in cases requiring intervention, a lack of evidence in favor of medical therapies was found. 2 Corticosteroids, propranolol, and vincristine have been used with minimal success, and only embolization and surgical resection have been shown to be definitive. 9,13,14 We present a rare, and sadly lethal, case of a neonate with a large CH and severe, overwhelming coagulopathy and multiorgan failure.Treatment options, which were carefully weighed for our patient, are

No abstract

No abstract