Hemangioma (segmental)

Diagnosis: Hemangioma (segmental)

Strawberry hemangioma, papules and plaques accompanied by many foci of regression and atrophic scars (previous ulcerated areas).

Clinical Presentation

Strawberry hemangioma, papules and plaques accompanied by many foci of regression and atrophic scars (previous ulcerated areas).

Clinical History

Submitted by Alaa Saad. Originally posted September 21, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Vascular malformation • Kaposiform hemangioendothelioma • Tufted angioma • Pyogenic granuloma • Kaposi sarcoma • Neuroblastoma (metastatic) • Myofibroma

Key Learnings

• Infantile hemangioma: most common tumor of infancy — GLUT1 positive • Classic phases: proliferative (0-12 months) → plateau → involution (years) • Complete involution in ~50% by age 5, ~90% by age 9 • PHACES syndrome: large facial hemangiomas with posterior fossa, hemangioma, arterial, cardiac, eye, sternal defects • Alarming locations requiring treatment: periocular (amblyopia), airway (subglottic), ulcerated, large facial • Propranolol is the first-line treatment for problematic infantile hemangiomas — revolutionary since 2008 • Timolol 0.5% gel (topical) for small, superficial lesions

Tags: hemangioma, segmental, alaa saad