Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Treatment of Symptomatic Focal Hepatic Hemangioma with Propranolol in Neonates: Is It Efficient?

  • Jana Lozar Krivec (Department of Neonatology, University Children's Hospital, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana) ;
  • Nina Lah (Community Health Centre) ;
  • Mojca Glusic (Department of Radiology, University Children's Hospital, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana) ;
  • Orjana Velikonja (Department of Haemato-oncology, University Children's Hospital, University Medical Centre Ljubljana) ;
  • Darja Paro-Panjan (Department of Neonatology, University Children's Hospital, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana)
  • Received : 2022.05.16
  • Accepted : 2022.11.13
  • Published : 2023.01.15
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Abstract

Hepatic hemangiomas (HH) - classified into congenital hepatic hemangiomas (CHH) or infantile hepatic hemangiomas (IHH) - are benign vascular tumors that are mainly asymptomatic, but may cause clinical problems that require treatment. While focal, multifocal, and diffuse IHH are responsive to propranolol treatment, CHH is mainly focal and thought to be resistant to treatment with propranolol. The clinical and imaging distinctions between CHH and IHH in cases of focal lesions can be challenging, while histopathological distinction is mostly lacking in the clinical setting. We report 4 neonatal symptomatic cases of focal HH treated with propranolol, with partial or complete resolution of the tumor, and the positive hemodynamic effect of propranolol in one case. We believe that although clear differentiation cannot be achieved between CHH and IHH without histopathological examination in cases of focal HH in neonates, propranolol treatment should be attempted in symptomatic cases since its benefits outweigh the possible small risk of side effects of propranolol.

Keywords

Acknowledgement

We are grateful to the parents who provided consent to use the data of their children.

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