title: Sirolimus for the Treatment of a Massive Capillary-Lymphatico-Venous Malformation: A Case Report.
abstract: Management of patients with complex vascular anomalies (VAs) is often associated with significant morbidity and mortality because of the lack of effective treatment modalities that may lead to significant improvement of the disease and/or healing. Recently, reports of treatment of patients with complex VAs with sirolimus revealed encouraging results. Sirolimus inhibits the mammalian target of rapamycin, which acts as a master switch of numerous cellular processes. We report a successful use of sirolimus for the treatment of a patient with a complex CLVM of the trunk and the right lower extremity believed to be untreatable. Our patient had 44 hospitalizations during the 10-year period, with various unsuccessful treatments and continuous deterioration of his clinical condition, ending up in a wheelchair. His condition reversed to normal everyday activities 9 months after initiation of sirolimus therapy. We conclude that sirolimus is a very promising therapeutic option for children with complex VAs of capillary-lymphatico-venous type.
authors.affiliation: Departments of Plastic and Reconstructive Surgery and Burns, and aleksandarvlahovic@yahoo.com.
authors.forename: Aleksandar M
authors.initials: AM
authors.lastname: Vlahovic
authors.affiliation: Physical Therapy and Rehabilitation, Institute for Mother and Child Health Care of Republic Serbia, New Belgrade, Serbia; and.
authors.forename: Natasa S
authors.initials: NS
authors.lastname: Vlahovic
authors.affiliation: Department of Pediatric and Adolescent Surgery, Medical University Graz, Graz, Austria.
authors.forename: Emir Q
authors.initials: EQ
authors.lastname: Haxhija
mesh_terms: D000015:Abnormalities, Multiple / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D042601:Lymphatic Vessels / Q000002:abnormalities*; D008297:Male; D020123:Sirolimus / Q000627:therapeutic use*; D054079:Vascular Malformations / Q000188:drug therapy*; D014680:Veins / Q000002:abnormalities*
chemical_list: D020123:Sirolimus
keywords: children; rapamycin; sirolimus; treatment; vascular anomalies