title: Clinical features and management of multifocal hepatic hemangiomas in children: a retrospective study.
abstract: Multifocal hepatic hemangioma (MHH) is a benign hepatic tumor that is commonly diagnosed in children with multiple cutaneous infantile hemangiomas (IHs). We present a review of all children with MHH at our institutions. Of the 42 patients, the median age at presentation of MHH was 2.5 months. Thirty-six (85.7%) patients had cutaneous IHs. Twelve (28.6%) patients were symptomatic at presentation. There was no significant association between the number of hepatic hemangiomas and the number of cutaneous IHs. Fourteen (33.3%) patients received some form of treatment for hepatic hemangiomas. The most common type of treatment was oral prednisone in 8 patients, followed by oral propranolol in 6 patients. Two patients were totally resistant to prednisone treatment. They died from congestive heart failure or respiratory distress and coagulopathy. Two patients with problematic facial IH were treated with intralesional triamcinolone injection. The remaining 26 patients were managed with imaging surveillance. On follow-up, all of the survivors had a favorable outcome. Our study suggests that the clinical features of MHH are variable. Our data emphasize the treatment strategy that aggressive treatment is indicated in symptomatic or progressive MHHs, whereas observation management of asymptomatic patients with a few small lesions is safe and appropriate.
authors.affiliation: Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Pediatric Intensive Care Unit, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Siyuan
authors.initials: S
authors.lastname: Chen
authors.affiliation: Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xiang
authors.affiliation: Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Vascular &Interventional Radiology, Chengdu Women and Children's Central Hospital, Chengdu, 610091, China.
authors.forename: Xingtao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Guoyan
authors.initials: G
authors.lastname: Lu
authors.affiliation: Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
mesh_terms: D000284:Administration, Oral; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage*; D011433:Propranolol / Q000008:administration & dosage*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D014221:Triamcinolone / Q000008:administration & dosage*
chemical_list: D014221:Triamcinolone; D011239:Prednisolone; D011433:Propranolol