title: [Giant infantile hepatic hemangioma: which therapeutic options?].
abstract: Infantile hepatic hemangioma is the third most frequent liver tumor in children and the most common below 6 months of age. Therapeutic options depend on clinical manifestations and should be tailored on an individual patient basis. We present the case of a 4 year old boy with neonatal diagnosis of large vascularized liver tumor with imagiological criteria of infantile hepatic hemangioma. We highlight the occurrence of heart failure and Kasabach-Merrit syndrome (thrombocytopenia, anemia) that have spontaneously regressed. During follow up, sequential imaging (ultrasound with Doppler, magnetic resonance imaging, dynamic contrast enhancement computed tomography) confirmed the hypothesis of IHH, allowing vascular mapping of the lesion. From the first year on, we observed a favorable course with progressive tumor regression. In the present case, a conservative approach has been maintained, but the best therapeutic option remains unclear. We highlight the specific features of this case, discussing the most cost-effective approach.
authors.affiliation: Unidade de Gastrenterologia Pediátrica. Departamento de Pediatria. Hospital de Santa Maria. Centro Académico de Medicina de Lisboa. Lisboa. Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Gonçalves
authors.affiliation: Serviço de Imagiologia Geral. Hospital Santa Maria (Centro Hospitalar Lisboa Norte). Lisboa. Portugal.
authors.forename: Luisa
authors.initials: L
authors.lastname: Lobo
authors.affiliation: Serviço de Cardiologia Pediátrica. Hospital Santa Cruz (Centro Hospitalar Lisboa Oeste). Carnaxide. Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Anjos
authors.affiliation: Clínica Nascer e Crescer. Barreiro. Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Salgueiro
authors.affiliation: Unidade de Gastrenterologia Pediátrica. Departamento de Pediatria. Hospital de Santa Maria. Centro Académico de Medicina de Lisboa. Lisboa. Portugal.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Lopes
mesh_terms: D002675:Child, Preschool; D006391:Hemangioma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male