IFOS, Dubai, United Arab Emirates, 17 - 21 January 2023, pp.1-2
Objectives:
Hemangiomas
are the the most common benign vascular tumors of childhood. Localization of
hemangioma and the risk of complications are important for the medical
treatment decision. Hemangiomas are most commonly located in the head and neck
region. Medical
treatment options are corticosteroids, propranolol, interferon alpha and chemotherapeutics.
Currently propranolol is the most common used agent for hemangioma treatment. Aim
of this study is to analize clinical characteristics and treatment responses of
our patients with head/neck hemangiomas.
Methods: Medical records of 264 patients with head/neck hemangiomas between 2006 to 2022 were evaluated retrospectively.
Results: The median age of admission was 4 mos (10 days-16 yrs),
F/M ratio was 2.18. History of premature birth rate was 26%, in 34% of the
cases, the family stated that hemangioma was present at birth. The localization of lesions were only at head and neck in 194/264
(73.5%), remaining patients have also additional hemangiomas on other parts of
body. Localization of
hemangiomas were as follows; periorbital 26.8% (n=71), periauricular 13.3% (n=35),
nasal 7.6% (n=20), mouth and lip 8.7% (n=23), subglottic 4.9% (n=13), laryngeal
0,4% (n=1),parotis 3% (n=8), cervical 10.6% (n=28), cheek 13.3% (n=35), forehead
3.7% (n=10), scalp 7.7% (n=20). One hundred
and thirty patients (49.2%) have been followed up without medical treatment and
regressed spontaneously without any complication. Remaining 134 patients
required medical treatment (propranolol in 122, corticosteroids in three cases,
both of them in 9 cases). Treatment indications were local complications
(haemorrhage, ulceration, infection) (14.9%), life threating organ dysfunction
(62.0%) and cosmetic (23.1%). Majority
of our cases received propranolol, and there was no observed propranolol
related side effects. The median duration of propranolol treatment was 13 mos (10 days – 35 mos).Sixteen patients are still receiving propranolol.Treatment
cessation was done in 100 cases.Complete regression was achieved in 61
patients,and partial regression was achieved in 36 cases with propranolol. The
patients who had subglottic hemangioma were the most problematic cases because
of respiratory and feeding difficulties.Three of them required
tracheostomy.Complete regression occured in all subglottic hemangiomas with
medical treatment. The
median follow-up period was 10 mos (0 mos – 9 yrs) for all patients.
Conclusions: Although childhood hemangiomas
can regress spontaneously, head/neck hemangiomas are sometimes required medical
treatment because the risk of ocular, feeding and respiratory complications. Rapid
regression of hemangiomas achieved within the use of propranolol.