Clinical and Histopathological Analysis of Infantile Hemangiomas

Chung, Hye Jin; Chung, Kee Yang

Abstract

BACKGROUND
Infantile hemangiomas (IH) are the most common tumor of childhood. However, accurate diagnosis of hemangiomas and vascular malformations remains a challenge for physicians because of confusing terminology, lack of knowledge regarding their biological and clinical behavior, and poorly understood diagnostic criteria. OBJECTIVES: The purpose of this study was to analyze the clinical and histopathologic findings of infantile hemangiomas in Korean patients. METHODS: Two hundred and fifty one cases of infantile hemangiomas were reviewed retrospectively. We analyzed the patients in terms of their clinical features and histopathological features. RESULTS AND CONCLUSIONS: 1. Hemangiomas were observed predominantly in females with the sex ratio of 1:2.4. Head and neck were the most commonly involved sites and 14 cases showed family history. 2. IH was evident at birth in 42.6% of the patients. The onset of the proliferating phase was pronounced during the first 1 to 3 months of life, followed by the involuting phase. IH that resolved after 6 years of age were more likely to leave a residual scar or telangiectasia than those which resolved before the age of 6. 3. Complications included ulcerations, erosions, secondary infection, bleeding tendency, ocular obstruction, nasal obstruction, respiratory difficulty and Kasabach-Merritt syndrome. 4. In H & E stains, hemangioma in the proliferating phase showed plump endothelial cells and increased endothelial cell activity with the formation of syncytial masses. The specimens in the involuting phase showed flattened endothelial cells and dilated lumens wheareas involuted lesions showed areas of fibrofatty infiltration.