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253 Management of Hemangiomas: A Single Center Experience
  1. G Tuysuz,
  2. N Ozdemir,
  3. B Kutlubay,
  4. T Celkan
  1. Pediatric Hematology-Oncology Dept., Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey

Abstract

Aim To share our experience of 185 (F/M: 2.4) patients with hemangiomas followed between 2003–2011 at Cerrahpasa Medical Faculty, Istanbul.

Results Onehundred-twenteight (69%) had a single lesion whereas 31% had multiple lesions. Most of the patients (n:94) were followed by a “watch and wait” policy and 40 of them did not require any medical or surgical intervention as the lesion convoluted on follow-up. Only 6 (3%) patients required surgery. Nine patients with lesion around eye required intralesional steroids to prevent visual disturbance. Bleomycin was used as a sclerosing treatment in 2 patients with a giant hemangioma. In 21 patients with multiple diffuse lesions causing cosmetic problems, interferon was given. Medical treatment was given in other patients on follow-up due to growth, ulceration, bleeding or persistance of the lesions at older ages; 14 were treated by systemic steroids, 73 by propranolol and 39 by combination therapy due to insuffient response. Propranolol was the first choice of treatment in patients diagnosed after 2008. All patients treated by propranolol were evaluated by echocardiography and electrocardiograpy, no cardiac side effects were noted. One patient under treatment presented with increased sweating and was found to have hypoglycemia associated with propranolol during periods of restricted oral intake. The drug was restarted increasing the frequency of breastfeeding with no further hypoglycemia attacks.

Conclusion The excellent clinical outcome and apparent lack of side effects of propranolol makes it a good choice as a first-line treatment for hemangiomas. Hypoglycemia may be noted in infants under propranolol in restricted periods of feeding.

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