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Volume 4
Journal of Pediatric Care
ISSN: 2471-805X
Page 60
JOINT EVENT
August 06-07, 2018 Madrid, Spain
&
2
nd
Edition of International Conference on
Adolescent Health & Medicine
18
th
International Conference on
Pediatrics Health
Pediatrics Health 2018
&
Adolescent Health 2018
August 06-07, 2018
Endovascular embolization of facial Hemangioma followed by surgical excision
Moutaz M Ragab
Cairo University, Egypt
Introduction:
Infantile hemangiomas are the commonest soft tissue tumors of infancy, with incidence 4% to 10% in children
below the age of 1 year, showing female predominance three to four times higher than male infants.Within the first weeks of
life, they enter a phase of rapid growth lasting for 3 to 6 months which may go on for 24 months. A period of stabilization for a
fewmonths follows with spontaneous involution usually occurring in several years. However, problematic hemangiomas occur
when they ulcerate, have massive growth, cause disfigurement, or affect normal function or cosmetic development. Common
locations for problematic hemangiomas include the face, ear, orbit, and airway. These hemangiomas subsequently require early
and aggressive treatment for ideal functional and cosmetic outcomes.
Case presentation:
10 months old female, full term, C.S. delivery, -ve consanguinity and -ve family history, presented to us
with facial hemangioma at the age of 4 months.Firstly, we started oral propranolol at dose 2mg/kg/day in 3 divided doses for
3 months that was increased to 3mg/kg/day in 3 divided doses for another 3months with regular monitoring for the heart rate
and the blood glucose level, however the response was not adequate and there was rapid prolefiration of the hemangioma.
At the age of 10 months we did MRI of the brain and both orbits that showed small left intra-orbital extra-coanal extension
with no intra-cranial extension and Multislice C.T. angiography of the extra and intra cranial carotid and vertebrobasilar
arterial systems that revealed main blood supply from the Ophthalmic branch of the left internal carotid artery, Endovascular
embolization was done using tiny plastic particles (200 μm) throught the Femoral artery access. 24 hours later we did near
total excision of the hemangioma. The residual part of the hemangioma delt with by 3 cycles of intralesional Triamcinolone
acetate injection at the dose of 0.5 mg/kg/injection on 4 weeks intervals. With adequate cosmetic result and reasonable parents
satisfaction.
Conclusion:
Combined management of such disfiguring, rapidly growing hemangioma is important to avoid functional loses
(theoretically in our case it could lead to diplopia, because it was encroching on the left eye).
moutazragab86@gmail.comJ Pediatr Care 2018, Volume 4
DOI: 10.21767/2471-805X-C3-012