Successful management of an infant with a giant hemangioma of the retroperitoneum and Kasabach-Merritt syndrome with alpha-interferon.
Giant vascular neoplasms in neonates generally require aggressive medical or surgical therapy for treatment of complications. Steroids, chemotherapy, embolization, radiation, and surgery have all been used with short-term beneficial and sometimes unknown long-term side effects. A new modality of treatment, alpha-interferon, has recently been described. The majority of hemangiomas in children involute by 8 years of age. Occasionally, hemangiomas can endanger vital structures and are associated with a consumption coagulopathy and thrombocytopenia (Kasabach-Merritt Syndrome). These hemangiomas occasionally do not respond to steroids, radiation therapy, cytotoxic drugs, or embolization. The mortality rates approach 50% in nonresponders. Alpha-interferon has been used in these children with life-threatening complications of hemangiomas with relief of symptoms. This case illustrates the potential use of alpha-interferon in the management of giant hemangiomas in children. This emerging form of biological therapy avoids the risks of radiation therapy, embolization, and surgery with only minimal side effects.
Hatley
R M
RM
Department of Surgery, Medical College of Georgia, Augusta 30912-4070.
Sabio
H
H
Howell
C G
CG
Flickinger
F
F
Parrish
R A
RA
D004211:Disseminated Intravascular Coagulation / Q000473:pathology / Q000628:therapy*; D004341:Drug Evaluation; D006392:Hemangioma, Cavernous / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000628:therapy*; D013577:Syndrome; D013921:Thrombocytopenia / Q000473:pathology / Q000628:therapy*
D016898:Interferon-alpha