Spontaneous evolution patterns of focal congenital hepatic hemangiomas: a case series of 25 patients

Rutten, Caroline; Ladarre, Delphine; Ackermann, O.; Gonzalès, Emmanuel; Guettier, Catherine; Franchi‐Abella, Stéphanie

doi:10.1007/s00247-021-05277-4

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…The postnatal growth of focal, congenital, GLUT1-negative hemangiomas has not been previously described in the liver. However, a recent study documenting the spontaneous evolution of untreated focal congenital hepatic lesions consistent with hepatic hemangioma has shown that some focal congenital lesions can show significant postnatal growth without evidence of intralesional hemorrhage [ 2 ]. “Although they disagree about the diagnostic criteria for congenital hepatic hemangioma (prenatal diagnosis and/or age at diagnosis ≤ 7 days and/or GLUT1-negative tumors), the age ranges for diagnosis of congenital hepatic hemangioma and infantile hepatic hemangioma overlap.” However, all the children included in our study were prenatally diagnosed, and four of them also had postnatal growth, one case in the observation group and three cases in the drug treatment group.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have suggested that FHH proliferates in utero and generally reaches peak size prior to or at birth. Three subtypes of congenital hemangiomas have been further described based on their evolution pattern: rapidly involuting (RICH), partially involuting (PICH), and noninvoluting (NICH) congenital hemangiomas [ 2 , 3 ]. Giant fetal hepatic hemangiomas (GFHHs), defined as tumors measuring more than 40 mm in diameter [ 4 ], are rare and can be associated with several life-threatening complications, such as high-output cardiac failure, consumptive coagulopathy, thrombocytopenia, and intratumoral bleeding.…”

Section: Introductionmentioning

confidence: 99%

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Postnatal treatment and evolution patterns of giant fetal hepatic hemangioma: a case series of 29 patients

Xie,

Huang,

Dong

et al. 2024

BMC Pediatr

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Objectives To explore the clinical characteristics, postnatal treatment and prognosis of giant fetal hepatic hemangioma (GFHH). Method Retrospective analysis was performed on children with giant fetal hepatic hemangioma (maximum tumor diameter > 40 mm) diagnosed by prenatal ultrasound and MRI from December 2016 to December 2020. These patients were observed and treated at the Children’s Hospital of Fudan University after birth. The clinical data were collected to analyze the clinical characteristics, treatment, and prognosis of GFHH using independent sample t tests or Fisher’s exact tests. Results Twenty-nine patients who were detected by routine ultrasound in the second and third trimester of pregnancy with giant fetal hepatic hemangiomas were included. The first prenatal ultrasound diagnosis of gestational age was 34.0 ± 4.3 weeks, ranging from 22 to 39 weeks. Of the patients, 28 had focal GFHHs and 1 had multifocal GFHHs. Surgery was performed, and the diagnosis was confirmed histopathologically in two patients. There were 8 cases with echocardiography-based evidence of pulmonary hypertension, 11 cases had a cardiothoracic ratio > 0.6, and 4 cases had hepatic arteriovenous fistula (AVF). The median follow-up time was 37 months (range: 14–70 months). During the follow-up, 12 patients received medical treatment with propranolol as the first-line therapy. The treatment group had a higher ratio of cardiothoracic ratio > 0.6 (P = 0.022) and lower albumin levels (P = 0.018). Four (14.8%) lesions showed postnatal growth before involuting. Complete response was observed in 13 (13/29) patients, and partial response was observed in 16 (16/29) patients. Conclusions Fetal giant hepatic hemangioma is mainly localized, and its clinical outcome conforms to RICH (rapidly involuting) and PICH (partially involuting), but some fetal giant hepatic hemangiomas will continue to grow after birth and then gradually decrease. For uncomplicated giant fetal hepatic hemangioma, postnatal follow-up is the main concern, while those with complications require aggressive medical treatment. Propranolol may have no effect on the volume change of GFHH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postnatal treatment and evolution patterns of giant fetal hepatic hemangioma: a case series of 29 patients

Xie,

Huang,

Dong

et al. 2024

BMC Pediatr

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“…4 However, recent studies have shown that about a third of congenital hemangiomas can grow after birth before their involution. 6 Regardless of the type, hemangiomas tend to show consistent imaging pattern consisting of T2-hyperintensity and peripheral nodular enhancement on arterial phase images followed by centripetal filling. 4 For the purpose of this study, a collective term "hepatic hemangioma" is used to include both infantile and congenital hemangiomas.…”

Section: Introductionmentioning

confidence: 95%

“…Of 33 final diagnoses in total, 8 were assigned by pathology (all 6 hepatoblastomas, 1 hemangioma, and 1 neuroblastoma metastases [primary lesion] were confirmed by histopathology) and 25 by corroborative reference standard with median follow-up period of 29 months (range 6-96 months). Final lesion diagnoses included hemangiomas (23), hepatoblastoma (6), AVM (2), and one each of metastases from neuroblastoma and infarction. The mean average diameter of largest lesions for the entire group was 3.2 cm (range 0.6-10.9 cm).…”

Section: Lesionsmentioning

confidence: 99%

Can Dynamic Contrast-Enhanced MRI Be Used to Differentiate Hepatic Hemangioma from Other Lesions in Early Infancy?

Halevy,

Sayed,

Shaikh

et al. 2024

Indian J Radiol Imaging

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Background Confident diagnosis of hepatic hemangioma on imaging can avoid biopsy in early infancy and helps guide conservative management. Purpose This article aims to determine if dynamic contrast-enhanced magnetic resonance imaging (MRI) can be used to differentiate liver hemangioma from other lesions in infants ≤ 100 days and to determine association of MRI features with hepatic lesions. Methods MRI performed for liver lesions were retrospectively reviewed to note imaging characteristics and the MRI diagnosis. Final diagnosis was assigned based on pathology in available cases and by corroborative standard of reference including overall clinical features, lab findings, and follow-up. Results Of 30 infants (18 boys, 12 girls; average age 42.2 days) included, 18 had solitary and 12 had multifocal lesions. Diagnoses in total 33 lesions included hemangiomas (23), hepatoblastoma (6), arteriovenous malformation (2), neuroblastoma metastases (1), and infarction (1). MRI and final diagnosis matched in 94% lesions with almost perfect agreement (kappa 0.86) for reader 1, and matched in 88% lesions with substantial agreement (kappa 0.71) for reader 2. Interobserver agreement for MRI diagnosis was substantial (kappa 0.62). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI in differentiating hemangioma from other lesions were 100, 90, 96, 100, and 97%, respectively. Centripetal (16/23) or flash (5/23) filling were only seen with hemangioma. There was no significant difference in alpha-fetoprotein elevation (p 0.08), average size (p 0.35), multifocality (p 0.38), and intralesional hemorrhage (p 1) between hemangioma and hepatoblastoma. Conclusion Centripetal filling on dynamic imaging and absence of washout are characteristic MRI features of hepatic hemangioma that can help to differentiate it from other lesions in early infancy.

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“…A new laparoscopic biopsy of the liver confirmed the diagnosis of Glut-1 positive IHH. However, because of the risk of malignancy reported in previous cases of IHH relapsing ( 6 , 7 ), we referred the child to a Liver Transplant Center. At the age 3 years, the patient underwent liver transplantation (LT), having considered the risk of developing hepatic angiosarcoma ( 8 ).…”

Section: Case Seriesmentioning

confidence: 99%

Consumptive Hypothyroidism due to Hepatic Hemangiomas: A Case Series and Review of the Literature

et al. 2022

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Spontaneous evolution patterns of focal congenital hepatic hemangiomas: a case series of 25 patients

Cited by 6 publications

References 21 publications

Postnatal treatment and evolution patterns of giant fetal hepatic hemangioma: a case series of 29 patients

Postnatal treatment and evolution patterns of giant fetal hepatic hemangioma: a case series of 29 patients

Can Dynamic Contrast-Enhanced MRI Be Used to Differentiate Hepatic Hemangioma from Other Lesions in Early Infancy?

Consumptive Hypothyroidism due to Hepatic Hemangiomas: A Case Series and Review of the Literature

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