Infantile Hemangioma

Abstract

Infantile hemangiomas are the most common tumors of infancy. They follow a predictable clinical course, beginning in the first 2 weeks of life with a proliferative phase, dominated by rapidly proliferating endothelial cells, lasting for up to a year. Over the next 7 to 10 years (involuting phase), proliferation is reduced, apoptosis increases, and growth of the lesions slows down and finally stops. The regressed lesion may leave behind flabby fatty tissue in place of an often disfiguring lesion, but many involuted lesions will leave the patient without the need for any corrective surgery. About 20% of hemangiomas are extremely disfiguring and destructive to normal tissue and may even be life threatening. In the last several years, much has been learned about molecular features of hemangioma and hemangioma-derived endothelial cells cultured in vitro, but the specific etiology remains unclear. The abundance of molecular clues from educated guesswork, histology, molecular screening studies, and immunohistochemistry with antibodies against specific proteins have prompted much speculation about the biochemical defect underlying hemangiogenesis, and many pathogenetic mechanisms have been proposed. This review summarizes the current state of knowledge about hemangioma, highlighting the proposed mechanisms that are best supported by the available data and the implications for therapeutic advances.

Prenatal Risk Factors for PHACE Syndrome: A Study Using the PHACE Syndrome International Clinical Registry and Genetic Repository

“…It is interesting that although sporadic infantile hemangiomas are often associated with prematurity, PHACE syndrome does not appear to be, the reasons for which remain unknown. In the case of sporadic infantile hemangiomas, it has been postulated that placental complications in utero drive both hemangioma development and prematurity (16). If such placental abnormalities also drove hemangioma development in PHACE syndrome, it is unclear why such placental abnormalities would not also lead to prematurity in PHACE syndrome as they are thought to do in the case of infantile hemangiomas.…”

Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children

“…However, about 20% of IHs are extremely disfiguring and destructive to normal tissue and may even be life threatening [5]. A central characteristic of most IHs is a predictable life cycle.…”

“…This is followed by an involution phase, spanning up to 7 years. Normal involution is thought to occur via cell senility and eventual apoptosis [5–7]. …”

“…Approximately 80% of IHs are found on the face and neck, favoring the anterior cheek, forehead, and preauricular area [5, 12]. The remaining IHs are found in decreasing order on the trunk, lower extremities, and upper extremities and occasionally on mucosal surfaces.…”

“…Corticosteroids, interferon-alfa, vincristine, laser therapy, and topical imiquimod are used in the treatment of IHs [5]. Surgical excision had also been reported to be effective.…”