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CASE REPORT
Rapidly involuting congenital haemangioma of the liver
  1. Deirdre Lewis1,
  2. Kevin Hachey1,
  3. Shannon Fitzgerald2,
  4. Ruben Vaidya2
  1. 1 Internal Medicine and Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, USA
  2. 2 Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, USA
  1. Correspondence to Dr Deirdre Lewis, deirdre.lewismd{at}baystatehealth.org

Summary

Rapidly involuting congenital haemangiomas (RICHs) are rare benign vascular tumours of infancy. They are generally asymptomatic, but can present with thrombocytopaenia and coagulopathy. Significant complications including life-threatening bleeding, high-output heart failure and liver failure, though rare, can occur. RICHs generally regress by 12–14 months of age and can be managed clinically with symptomatic treatment, watchful waiting and close monitoring of the size of the haemangioma. Medical management (corticosteroids, propranolol) has not shown to be effective, in contrast to infantile haemangioma which will not regress spontaneously and has been noted to respond to medical therapy. Awareness of this diagnosis is important to prevent unnecessary medical and surgical intervention. Here, we present a case of a full-term infant with RICH who presented with thrombocytopaenia and abnormal coagulation profile. The coagulopathy was treated symptomatically, while the lesion was observed with serial ultrasounds and gradually decreased in size.

  • hemangioma
  • neonatal intensive care
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Footnotes

  • Contributors All authors contributed to the case report equally. DL and RV conducted the literature review and prepared the initial draft. DL, KH, SF and RV conceptualised and critically reviewed the manuscript, recommended revisions and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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