[Infantile hemangioendothelioma of the liver--sonographic diagnosis and follow-up].
OBJECTIVE
Hepatic haemangioendothelioma is the most frequently observed hepatic tumour of early infancy. Lesions may cause life-threatening disease due to av-shunt-related cardiac failure, Kasabach-Merritt syndrome or encroachment on surrounding tissue. In this paper, the value of ultrasonography at initial work-up as well as during follow-up under various management strategies is discussed.


METHODS
Retrospective analysis of sonographic and clinical data as well as outcome of 14 patients.


RESULTS
The tumours may present initially with a typical sonographic pattern of a roundish solitary lesion consisting predominantly of massively perfused, tortuous cavities. In these cases, histological verification of the diagnosis is not mandatory, provided serological tumour markers are negative. Multifocal haemangioendotheliomata with a solid appearance, however, cannot be reliably distinguished from other entities sonographically. Tumour development - with or without therapy - can be followed up precisely using repeated ultrasound evaluations of tumour volume and sono-morphology as well as Doppler examination of tumour perfusion.


CONCLUSIONS
Guidelines for the management of these patients are discussed, based on our experience and a review of the literature. Sonography proves to be of outstanding importance.
Kardorff
R
R
Marien-Hospital Wesel, Klinik für Kinder- und Jugendmedizin, Germany. ruediger.kardorff@marien-hospital-wesel.de
Fuchs
J
J
Peuster
M
M
Rodeck
B
B
D005260:Female; D005500:Follow-Up Studies; D006390:Hemangioendothelioma / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal