Use of thalidomide to diminish growth velocity in a life-threatening congenital intracranial hemangioma.
J Neurosurg Pediatr
; 2(2): 125-9, 2008 Aug.
Article
em En
| MEDLINE
| ID: mdl-18671617
ABSTRACT
Infantile or capillary hemangioma is the most common vascular tumor of childhood. The tumors most frequently affect the head and neck area, but rare cases of intracranial lesions have been reported. Their natural history is marked by initial rapid growth velocity followed by a plateau and, in most cases, subsequent involution. Although the lesions are considered benign, 10% of affected children develop life-threatening complications (mortality rate 20-80% in this subgroup). When surgical intervention or other methods of local control are not possible, therapeutic options are limited. Corticosteroids have been the mainstay of therapy but therapeutic response is not predictable and the infectious risk is not negligible. Interferon alpha-2a may also be effective but has significant toxicities. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) have been implicated in the pathogenesis of hemangiomas, and antiangiogenesis agents are being evaluated in the treatment of these tumors. Thalidomide may be an ideal therapy for life-threatening hemangiomas because it inhibits new blood vessel formation by antagonizing both the bFGF and VEGF pathways and has a more acceptable toxicity profile than other agents. The authors present the case of an infant born with a life-threatening, unresectable intracranial hemangioma in which treatment with thalidomide resulted in a good clinical outcome.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Talidomida
/
Neoplasias Encefálicas
/
Hemangioma Capilar
/
Inibidores da Angiogênese
Tipo de estudo:
Prognostic_studies
Limite:
Female
/
Humans
/
Newborn
Idioma:
En
Revista:
J Neurosurg Pediatr
Assunto da revista:
NEUROCIRURGIA
/
PEDIATRIA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Estados Unidos