Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?

Detalhes bibliográficos
Autor(a) principal: Gonçalves, Cristina
Data de Publicação: 2013
Outros Autores: Lobo, Luisa, Anjos, Rui, Salgueiro, Carlos, Lopes, Ana Isabel
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899
Resumo: Infantile Hepatic Hemagioma is the third most frequent liver tumor in children and the most common below 6 months of age. Therapeutic options depend on clinical manifestations and should be tailored on an individual patient basis. We present the case of a 4 year old boy with neonatal diagnosis of large vascularized liver tumor with imagiological criteria of Infantile Hepatic Hemagioma. We highlight the occurrence of heart failure and Kasabach-Merrit syndrome (thrombocytopenia, anemia) that have spontaneously regressed. During follow up, sequential imaging (ultrasound with Doppler, magnetic resonance imaging, dynamic contrast enhancement computed tomography) confirmed the hypothesis of IHH, allowing vascular mapping of the lesion. From the first year on, we observed a favorablecourse with progressive tumor regression. In the present case, a conservative approach has been maintained, but the best therapeutic option remains unclear. We highlight the specific features of this case, discussing the most cost - effective approach.
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spelling Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?Hemangioma Hepático Infantil Gigante: Que Opções Terapêuticas?Infantile Hepatic Hemagioma is the third most frequent liver tumor in children and the most common below 6 months of age. Therapeutic options depend on clinical manifestations and should be tailored on an individual patient basis. We present the case of a 4 year old boy with neonatal diagnosis of large vascularized liver tumor with imagiological criteria of Infantile Hepatic Hemagioma. We highlight the occurrence of heart failure and Kasabach-Merrit syndrome (thrombocytopenia, anemia) that have spontaneously regressed. During follow up, sequential imaging (ultrasound with Doppler, magnetic resonance imaging, dynamic contrast enhancement computed tomography) confirmed the hypothesis of IHH, allowing vascular mapping of the lesion. From the first year on, we observed a favorablecourse with progressive tumor regression. In the present case, a conservative approach has been maintained, but the best therapeutic option remains unclear. We highlight the specific features of this case, discussing the most cost - effective approach.Os hemangiomas hepáticos infantis constituem o terceiro tumor hepático mais frequente na criança e o mais frequente antes dos seis meses. As opções terapêuticas são determinadas pela apresentação clínica, devendo ser individualizadas. Apresenta-se o caso de uma criança actualmente com quatro anos de idade, com diagnóstico neonatal de volumosa malformação hepática vascularizada, com critérios imagiológicos compatíveis com hemangioma hepático infantil. Destaca-se a ocorrência inicial de Síndrome de Kasabach-Merrit (trombocitopenia, anemia) e insuficiência cardíaca que resolveram espontaneamente. Ao longo do período de seguimento, o estudo imagiológico evolutivo (ecografia, doppler ressonância magnética e tomografia computorizada com administração de contraste endovenoso) confirmou a hipótese de HHI ao permitir o mapeamento vascular detalhado. A partir do primeiro ano de vida, constatou-se evolução favorável com redução progressiva da massa. Embora se tenha mantido atitude conservadora, a melhor abordagem e intervenção nesta entidade, permanece controversa. Salientam-se as particularidades deste caso, discutindo a abordagem com melhor relação custo-benefício.Ordem dos Médicos2013-12-20info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/octet-streamapplication/octet-streamapplication/octet-streamapplication/octet-streamhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899oai:ojs.www.actamedicaportuguesa.com:article/899Acta Médica Portuguesa; Vol. 26 No. 6 (2013): November-December; 750-754Acta Médica Portuguesa; Vol. 26 N.º 6 (2013): Novembro-Dezembro; 750-7541646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/3819https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6834https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6835https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6836https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6837Gonçalves, CristinaLobo, LuisaAnjos, RuiSalgueiro, CarlosLopes, Ana Isabelinfo:eu-repo/semantics/openAccess2022-12-20T10:57:08Zoai:ojs.www.actamedicaportuguesa.com:article/899Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:50.414100Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
Hemangioma Hepático Infantil Gigante: Que Opções Terapêuticas?
title Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
spellingShingle Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
Gonçalves, Cristina
title_short Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
title_full Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
title_fullStr Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
title_full_unstemmed Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
title_sort Giant Infantile Hepatic Hemagioma: Which Terapeutic Options?
author Gonçalves, Cristina
author_facet Gonçalves, Cristina
Lobo, Luisa
Anjos, Rui
Salgueiro, Carlos
Lopes, Ana Isabel
author_role author
author2 Lobo, Luisa
Anjos, Rui
Salgueiro, Carlos
Lopes, Ana Isabel
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Gonçalves, Cristina
Lobo, Luisa
Anjos, Rui
Salgueiro, Carlos
Lopes, Ana Isabel
description Infantile Hepatic Hemagioma is the third most frequent liver tumor in children and the most common below 6 months of age. Therapeutic options depend on clinical manifestations and should be tailored on an individual patient basis. We present the case of a 4 year old boy with neonatal diagnosis of large vascularized liver tumor with imagiological criteria of Infantile Hepatic Hemagioma. We highlight the occurrence of heart failure and Kasabach-Merrit syndrome (thrombocytopenia, anemia) that have spontaneously regressed. During follow up, sequential imaging (ultrasound with Doppler, magnetic resonance imaging, dynamic contrast enhancement computed tomography) confirmed the hypothesis of IHH, allowing vascular mapping of the lesion. From the first year on, we observed a favorablecourse with progressive tumor regression. In the present case, a conservative approach has been maintained, but the best therapeutic option remains unclear. We highlight the specific features of this case, discussing the most cost - effective approach.
publishDate 2013
dc.date.none.fl_str_mv 2013-12-20
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6834
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6835
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6836
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/899/6837
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 26 No. 6 (2013): November-December; 750-754
Acta Médica Portuguesa; Vol. 26 N.º 6 (2013): Novembro-Dezembro; 750-754
1646-0758
0870-399X
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