RESUMO
We report the case of a neonate who presented with a left abdominal flank mass and hemodynamic instability signs, with the final diagnosis of left renal vein thrombosis complicated with inferior vena cava thrombosis and perirenal hematoma. We illustrate the importance of an early imaging approach with ultrasound and Doppler evaluation to finally diagnose perinatal renal vein thrombosis and its complications. Teaching Point: An early imaging approach with ultrasound and Doppler evaluation is fundamental to finally diagnose perinatal renal vein thrombosis and its complications.
RESUMO
Two unrelated neonates were born with a large purplish congenital mass of the thigh and forearm. Both showed signs of heart dysfunction, and one of them had anaemia and thrombocytopenia. The imaging assessment of the lesions showed well-defined subcutaneous solid masses with an exuberant vascular component. Both were kept under surveillance and maintenance therapy. A progressive dimensional reduction of the lesions supported the diagnosis of rapidly involuting congenital haemangioma (RICH). RICH is a rare vascular tumour that presents as a congenital purplish bulky mass. The diagnosis depends on the clinical evaluation of the lesion and the imaging characterisation of its solid components and vascular network. RICH may be complicated by high-output heart failure, anaemia and thrombocytopenia. Despite its exuberant presentation, it undergoes involution in the first year of life; therefore, early invasive therapies should be avoided. It is essential to detect any dimensional increase, suggesting more aggressive diagnoses, such as kaposiform haemangioendothelioma.
