title: Malignant differential diagnosis in children referred for infantile hemangioma.
abstract: OBJECTIVE
  Early age malignant tumors can mimic benign infantile hemangioma (IH). The purpose of this study was to determine the percentage of patients referred with a diagnosis of IH that were misdiagnosed, including that of those who in fact had malignant lesions and to assess how the misdiagnosis was reached.
  
  
  METHODS
  From April 2003 through December 2009, all records of children, referred with a diagnosis of IH, were studied to determine the definitive diagnosis. Characteristics of the children with malignant diagnoses and of their diagnostic process were retrospectively analyzed.
  
  
  RESULTS
  The referral diagnosis "hemangioma" was recorded in 423 children and confirmed in 89%. Thirty-nine children were rediagnosed with a vascular malformation (7%) or other benign anomalies (2%). The 7 (2%) remaining children were diagnosed with a malignancy.
  
  
  CONCLUSIONS
  In cases where the diagnosis of IH is equivocal, biopsy has to be performed in a specialized center to prevent delay.
authors.affiliation: From the *Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center; and †Department of Plastic and Reconstructive Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
authors.forename: Marije J
authors.initials: MJ
authors.lastname: Hoornweg
authors.forename: Carla I J M
authors.initials: CI
authors.lastname: Theunissen
authors.forename: J Joris
authors.initials: JJ
authors.lastname: Hage
authors.forename: Chantal M A M
authors.initials: CM
authors.lastname: van der Horst
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D018324:Hemangioma, Capillary / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012878:Skin Neoplasms / Q000175:diagnosis*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis*; D054079:Vascular Malformations / Q000175:diagnosis