Presentación de casos clínicos RESUMENEl hemangioendotelioma hepático infantil es el tumor vascular del hígado más frecuente en los niños. El diagnóstico se puede plantear sin una confirmación histológica cuando los hallazgos clínicos, analíticos e imagenológicos son muy sugestivos, sobre todo en los niños menores de 6 meses, ya que la biopsia no está exenta de complicaciones graves. Se presenta una paciente de 4 días de vida y 3500 g de peso, que sufrió un shock hipovolémico como complicación de la biopsia de un hemangioendotelioma hepático infantil multifocal, y posteriormente manifestaciones clínicas de insuficiencia cardíaca y plaquetopenia. Por el estado crítico de la niña, se escogió el tratamiento con prednisona, que se mantuvo durante 5 meses, y se obtuvo la remisión completa del tumor. Se resalta la importancia de la ecografía Doppler como medio diagnóstico seguro y no invasivo, y se comenta la conducta ante esta enfermedad. Palabras clave: pediatría, hemangioma, hígado, hemangioendotelioma hepático. SUMMARYInfantile hepatic hemangioendothelioma is the most common vascular tumor of the liver in infancy. The diagnosis can be enunciated without histological definition, if the clinical, analytical and images findings are very suggestive; particularly in children less than six months old, because the biopsy is not exempt of complications. We report a female patient, four days old and 3500 g, who developed a hypovolemic shock as a complication of the biopsy from a multifocal infantile hepatic hemangioendothelioma. She developed clinical manifestations of cardiac failure and thrombocytopenia. Because of the critical clinical status we choose the medical treatment with prednisone which was administered for five month and complete remission of the tumor was obtained. We highlight the Doppler ultrasonography as a safe and no invasive diagnosis method. Management of this disease is commented as well.
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