Hemangiomas in children. Treatment trends

Abstract

Introduction Vascular tumors are some of the most common birth defects. In 1982 Muleikin J.B. and Clowacki I. proposed the biological classification system, dividing the vascular maformative anomalies into the biologically active ones (hemangiomas) and biologically inactive - vascular malformations. Purpose The aim of this paper is to clarify the clinical anatomical differences that would facilitate the diagnosis and to present therapeutic options (some new ones) regarding hemangiomas. Material and methods From the clinical material of the pediatric surgery service of Natalia Gheorghiu SPNC for Pediatric Surgery studied over a period of 20 years (2000-2020) we selected for our study a number of 1784 patients with hemangiomas. We evaluated the epidemiology, location, age at which they were diagnosed, complications and methods of diagnosis and treatment. We studied the advantages of intralesional injection of Bleomycin, Corticosteroids, intratumoral and extravascular embolization, laser therapy, mechanical compression, cryotherapy, the use of Propanolol, as well as surgical treatment. Results Patients with hemangiomas of various locations (cutaneous, pulmonary, reteroperitoneal, hepatic, renal, spinal, facial, scalp, intranasal, labial) benefited from differentiated treatment, on a case-by-case basis. Conclusions 1. Our study shows the advantages of the non-operative method of treatment of hemangiomas in newborns and infants by intralesional therapy of Prednisolone. 2. The attitude of our clinic is to solve hemangiomas either conservatively or surgically and not to wait for regression, due to their unpredictable evolution. 3. Surgery must be preceded by complex investigations (USG, CT with angiography, Doppler) to clearly determine the hemangioma and avoid surgical complications.