title: Characteristics of noninvoluting congenital hemangioma: a retrospective review.
abstract: BACKGROUND
  Noninvoluting congenital hemangioma (NICH) is a distinct vascular tumor of infancy.
  
  
  OBJECTIVE
  We describe the clinical characteristics, histopathology, imaging, and natural history of NICH and compare our findings with previous reports.
  
  
  METHODS
  We conducted a retrospective review of charts and photographic databases from 2 vascular anomaly centers over a 15-year period.
  
  
  RESULTS
  Thirty cases of NICH were identified. All patients had fully formed vascular lesions at birth that demonstrated a nonprogressive course. The trunk and lower extremities were preferred sites and there was a female predominance. Thirteen of 30 patients reported pain. Focal necrosis and scarring was seen in a minority. Doppler studies, when performed, confirmed high vascular flow. Microscopic evaluation of 4 excised lesions showed lobular areas of endothelial cell proliferation directly adjacent to ectatic malformed vessels. Immunohistochemical studies demonstrated absence of glucose transporter-1 protein expression in every case. Wilms tumor-1 positivity was observed in lobular areas. The larger vessels did not stain with Wilms tumor-1, but some displayed D2-40 positivity.
  
  
  CONCLUSIONS
  Patients were referred to university-based pediatric vascular anomaly centers, with potential bias toward more severe or extensive cases.
  
  
  CONCLUSIONS
  This retrospective study highlights the unique clinical and histopathologic features of NICH.
authors.affiliation: Department of Dermatology, Kaiser Permanente, San Rafael, California.
authors.forename: Pristine W
authors.initials: PW
authors.lastname: Lee
authors.affiliation: Department of Dermatology, University of California, San Francisco, California.
authors.forename: Ilona J
authors.initials: IJ
authors.lastname: Frieden
authors.affiliation: Department of Dermatology, Emory University, Atlanta, Georgia.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: Streicher
authors.affiliation: Department of Dermatology, University of California, San Francisco, California; Department of Pathology, University of California, San Francisco, California.
authors.forename: Timothy
authors.initials: T
authors.lastname: McCalmont
authors.affiliation: Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: ahaggstr@iu.edu.
authors.forename: Anita N
authors.initials: AN
authors.lastname: Haggstrom
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D051272:Glucose Transporter Type 1 / Q000097:blood; D006391:Hemangioma / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D018608:Ultrasonography, Doppler; D025721:WT1 Proteins / Q000097:blood
chemical_list: D051272:Glucose Transporter Type 1; D025721:WT1 Proteins; C583751:WT1 protein, human
keywords: infantile hemangiomas; noninvoluting congenital hemangioma; vascular tumors