Malignant differential diagnosis in children referred for infantile hemangioma.

BACKGROUND AND AIM: Early age malignant tumors can mimic benign infantile hemangioma (IH). The purpose of this study was to determine the percentage of patients referred with a diagnosis of IH that were misdiagnosed, including that of those who in fact had malignant lesions and to assess how the misdiagnosis was reached. METHODS: From April 2003 through December 2009, all records of children, referred with a diagnosis of IH, were studied to determine the definitive diagnosis. Characteristics of the children with malignant diagnoses and of their diagnostic process were retrospectively analyzed. RESULTS: The referral diagnosis "hemangioma" was recorded in 423 children and confirmed in 89%. Thirty-nine children were rediagnosed with a vascular malformation (7%) or other benign anomalies (2%). The 7 (2%) remaining children were diagnosed with a malignancy. CONCLUSIONS: In cases where the diagnosis of IH is equivocal, biopsy has to be performed in a specialized center to prevent delay.