RESUMEN
Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor that does not metastasize. We report two unique cases of KHE involving the right hemithorax and the upper ipsilateral extremity. Kasabach-Merrit phenomenon and osteolytic lesions in the scapula were observed in both cases.
Asunto(s)
Hemangioendotelioma/patología , Imagenología Tridimensional , Síndrome de Kasabach-Merritt/patología , Osteólisis/diagnóstico , Sarcoma de Kaposi/patología , Escápula/patología , Neoplasias Cutáneas/patología , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Niño , Angiografía por Tomografía Computarizada/métodos , Femenino , Hemangioendotelioma/complicaciones , Hemangioendotelioma/diagnóstico , Hemangioendotelioma/tratamiento farmacológico , Humanos , Lactante , Síndrome de Kasabach-Merritt/complicaciones , Síndrome de Kasabach-Merritt/diagnóstico , Síndrome de Kasabach-Merritt/tratamiento farmacológico , Masculino , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Osteólisis/complicaciones , Pronóstico , Enfermedades Raras , Medición de Riesgo , Sarcoma de Kaposi/complicaciones , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/tratamiento farmacológico , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológicoAsunto(s)
Anomalías del Sistema Digestivo , Vólvulo Intestinal , Anomalías del Sistema Digestivo/complicaciones , Anomalías del Sistema Digestivo/diagnóstico por imagen , Humanos , Vólvulo Intestinal/complicaciones , Vólvulo Intestinal/diagnóstico por imagen , Vólvulo Intestinal/cirugía , Vena Porta/diagnóstico por imagenRESUMEN
During the last 5 years, many studies have shown the efficacy of propranolol as first-line treatment for infantile hemangiomas (IHs), but not much has been written about the role of propranolol beyond the proliferation phase of IH (>1 year). Our aim was to assess propranolol efficacy and safety in the treatment of patients older than 1 year. A retrospective study of patients older than 1 year diagnosed with IH and treated in our vascular anomalies clinic between 2009 and 2013 was performed. Eighteen patients older than 1 year with a diagnosis of IH (15 girls, 3 boys) were identified. The mean age at the time of initiation of treatment was 25.7 months (range 13-72 mos). Single lesions were observed in 13 patients and multiple lesions in 5. Fifteen patients had focal lesions and three had segmental. The median duration of treatment with oral propranolol was 11.8 months (range 2-33 mos). Complete response was observed in 72.2% of the patients and partial response in 27.8%. Recurrence was observed in three patients 4.7 months after completion of therapy (range 0.3-8 mos). These patients required further therapy with propranolol for 6 more months. Bradycardia was documented in two patients and night terrors in one patient, which led to discontinuation of treatment. In our experience, propranolol may be useful in the treatment of IHs beyond the proliferation phase (>1 year old), but more studies are needed to support this observation.
Asunto(s)
Hemangioma/tratamiento farmacológico , Propranolol/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Vasodilatadores/uso terapéutico , Administración Oral , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Propranolol/administración & dosificación , Estudios Retrospectivos , Resultado del Tratamiento , Vasodilatadores/administración & dosificaciónRESUMEN
We report a 13-year-old girl who presented with a recurrent abdominal pain that started after her menarche. The abdominal palpation revealed tenderness over the left ovarian point. The laboratory study, ultrasonography, and abdominal X-ray were normal. The computed tomography and magnetic resonance imaging showed a double left renal vein with a retroaortic component, an increased left parauterine circulation, and ipsilateral ovarian vein engorgement. A diagnostic and therapeutic phlebography allowed a selective catheterization of a group of pelvic varicose veins draining to the left ovarian and to the internal iliac veins. There were no complications during the procedure and the symptoms disappeared 2 days later. Circumaortic left renal vein may cause hematuria, proteinuria, pelvic congestion syndrome, and massive hemorrhage during surgery. A conservative treatment is recommended for patients without gynecourological/renal symptoms or with mild hematuria. The endovascular treatment by gonadal venous embolization is safe and effective.