A case of pericardial hemangioma with consumption coagulopathy cured by radiotherapy

“…The natural history of cardiac hemangiomas is unpredictable, ranging from dormancy, to accelerated growth, to spontaneous regression/involution [8]. Several treatment modalities have been reported for pericardial hemangioma, including surgical resection, steroid therapy, interferon therapy, radiotherapy and conservative therapy, however, therapeutic strategy remains controversial [9,10]. According to previous reports, even asymptomatic pericardial tumors may cause ventricular arrhythmias, cardiac tamponade, sudden death, local progression, or systemic dissemination of the neoplastic process, irrespective of tumor size [11,12].…”

Section: Discussionmentioning

confidence: 99%

Hemangioma located just above the left main coronary artery, in a subject who had cardiac arrest due to ventricular fibrillation, led to a diagnosis of Brugada syndrome

Nakamura

Funabashi

Miyauchi

et al. 2008

International Journal of Cardiology

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“…When radiotherapy is used, the lowest dose should be used so that the incidence of possible late effects and secondary malignancies is reduced. Cavernous haemangiomas with thrombocytopenia generally will respond to total radiotherapy doses of 7-20 Gy [44], although in some cases a dose of 10 Gy by conventional fractionation appears to be sufficient [15]. In this case, a dose of 9.5 Gy was necessary for the control of symptoms.…”

Section: Radiotherapymentioning

confidence: 93%

Kasabach–Merritt syndrome: a review of the therapeutic options and a case report of successful treatment with radiotherapy and interferon alpha

Hesselmann¹,

Micke²,

Marquardt³

et al. 2002

BJR

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We describe the successful treatment of a neonate with Kasabach-Merritt syndrome who received local irradiation and interferon alpha therapy after failure of corticosteroid treatment. A male neonate, born after an uneventful pregnancy, had a huge haemangioma involving the upper right cervical region as well as severe thrombocytopenia. He was treated with corticosteroids, interferon alpha and radiotherapy. Prednisolone therapy (5 mg kg(-1) day(-1)) was started at 41 days of age. No therapeutic effect was observed after 2 weeks. At this time the tumour size had increased dramatically, platelet counts had decreased progressively and coagulation abnormalities had developed. Because corticosteroid therapy had been ineffective and the child was in a life-threatening condition, irradiation was delivered up to a total dose of 9.5 Gy in five fractions. Simultaneously, prednisolone therapy was slowly decreased and interferon alpha therapy (3 million U m(-2) day(-1)) was started and continued for 6 weeks. After irradiation with 9.5 Gy and beginning interferon alpha therapy, the tumour decreased in size and coagulation parameters normalized within 4 weeks. 6 months later, platelet counts and coagulation parameters were still normal. The tumour had further decreased in size. No acute severe side effects were observed. Radiation therapy combined with interferon alpha treatment is an alternative treatment modality when high dose corticoid steroid therapy has been ineffective in patients with Kasabach-Merritt syndrome, despite the risks of growth delay and secondary malignancy. In children showing no response to corticosteroids, radiotherapy and/or interferon alpha should be considered in Kasabach-Merritt syndrome.

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A case of pericardial hemangioma with consumption coagulopathy cured by radiotherapy

Abstract: An infantile case of pericardial hemangioma with large pericardial effusion and consumption coagulopathy is described. This is the first reported case of pericardial hemangioma cured by radiotherapy.

Cited by 22 publications

References 4 publications

Symptomatic cardiac hemangioma resected on the first day of life

Symptomatic cardiac hemangioma resected on the first day of life

Hemangioma located just above the left main coronary artery, in a subject who had cardiac arrest due to ventricular fibrillation, led to a diagnosis of Brugada syndrome

Kasabach–Merritt syndrome: a review of the therapeutic options and a case report of successful treatment with radiotherapy and interferon alpha

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