Successful treatment of a large hemangioma with propranolol

Abstract

Hemangiomas are the most common vascular tumors in children. They occur in 8-12% of all infants and in 22% of premature infants (female: male = 3: 1). Hemangiomas are usually sporadic; their etiology is unknown. A premature female infant, born at 28 weeks of gestation, presented with a large hemangioma of the right thoracic wall. Within the first few weeks, the hemangioma showed rapid horizontal and vertical growth as well as ulceration, which led us to initiate systemic therapy. The effectiveness of propranolol (non-selective ss-blocker) in the management of severe cases of hemangioma has been shown in a recent series of cases. We began oral propranolol treatment, in close interdisciplinary cooperation. After a few days of therapy, the tumor had stopped expanding. After 18 weeks, there has been marked regression but the therapy is still being continued. We propose that propranolol may be an effective and relatively well tolerable alternative in the management of selected cases of severe hemangiomas in infancy, providing interdisciplinary cooperation between dermatologists and pediatricians is available.

Use of propranolol for treatment of hemangiomas in PHACE syndrome

“…She is being followed to assess the long-term course of her hemangiomas treated with propranolol. Another case report of an infant born at 28 weeks with large thoracic hemangiomas was published by Mousa et al 12 with similar results. Propranolol seems to have had impressive effects in this patient and may hold promise for the future; however, its use for this disorder is currently not approved by the Food and Drug Administration.…”

Propranolol: useful therapeutic agent for the treatment of ulcerated infantile hemangiomas

“…After the initial observation, other case reports have described its therapeutic effect on ulcerated IH [5][6][7]. In this series, the duration of ulceration before commencement of propranolol was 2 to 10 weeks, and all ulcers healed between 2 and 6 weeks.…”

“…Specialized dressings, corticosteroids, pulsed-dye laser, chemotherapeutic agents, and surgery have all been advocated. There are a few case reports published on the successful use of propranolol in treating ulcerated IHs [5][6][7]. We present 6 cases at a single pediatric center with ulcerated IHs, which were successfully treated with oral propranolol at 2 mg/kg per day.…”

Beta-blockers for the treatment of problematic hemangiomas

“…Hemangiomas are the most common vascular tumours, occurring in 8% to 12% of all infants and in 22% of premature infants (2). They usually occur sporadically with an unknown etiology.…”