LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies.
OBJECTIVE
To define the clinical spectrum of regional congenital anomalies associated with large cutaneous hemangiomas of the lower half of the body, clarify risk for underlying anomalies on the basis of hemangioma location, and provide imaging guidelines for evaluation.


METHODS
We conducted a multi-institutional, retrospective case analysis of 24 new patients and review of 29 published cases.


RESULTS
Hemangiomas in our series tended to be "segmental" and often "minimal growth" in morphology. Such lesions were often extensive, covering the entire leg. Extensive limb hemangiomas also showed potential for extracutaneous anomalies, including underlying arterial anomalies, limb underdevelopment, and ulceration. The cutaneous hemangioma and underlying anomalies demonstrated regional correlation. Myelopathies were the most common category of associated anomalies.


CONCLUSIONS
We propose the acronym "LUMBAR" to describe the association of Lower body hemangioma and other cutaneous defects, Urogenital anomalies, Ulceration, Myelopathy, Bony deformities, Anorectal malformations, Arterial anomalies, and Renal anomalies. There are many similarities between LUMBAR and PHACE syndrome, which might be considered regional variations of the same. Although guidelines for imaging are suggested, prospective studies will lead to precise imaging recommendations and help determine true incidence, risk and long-term outcomes.
Iacobas
Ionela
I
Department of Pediatric Hematology Oncology, Baylor College of Medicine, Houston, TX, USA.
Burrows
Patricia E
PE
Frieden
Ilona J
IJ
Liang
Marilyn G
MG
Mulliken
John B
JB
Mancini
Anthony J
AJ
Kramer
Daniela
D
Paller
Amy S
AS
Silverman
Robert
R
Wagner
Annette M
AM
Metry
Denise W
DW
D000465:Algorithms; D000013:Congenital Abnormalities / Q000175:diagnosis; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000150:complications* / Q000175:diagnosis