Conservative management of neonatal hepatic hemangioma: a report from one institute.

Pediatr Surg Int. 2009 May 5; Dong KR, Zheng S, Xiao XPURPOSE: To summarize the conservative treatment of neonatal hepatic hemangioma at one institute. PATIENTS AND MATERIALS: Fifteen cases of neonatal hepatic hemangioma were managed in our hospital during the previous 5 years. Initial symptoms, combination symptoms, diagnosis, and treatment were analyzed. RESULTS: Initial symptoms were abdominal mass, hepatomegaly, jaundice, and pneumonia. Combination symptoms were multiple skin hemangiomas, pneumonia, and cardiac insufficiency. Ultrasound and CT showed the typical characteristics of the liver hemangioma. There were three types of hepatic hemangioma: nine cases had a single focus, four cases were multiple foci, and two had diffuse changes in the liver. The diameter of a single focus in this group was about 53-99 mm. Four cases of single focus received resection and two received biopsy. Six cases received corticosteroid treatment. The other five cases were kept under observation only. Those with cardiac insufficiency and pneumonia received diuretics and antibiotic treatment. One neonate with cardiac insufficiency and pneumonia had postoperative MODS and died. One patient having multi-focus in the liver gave up the treatment after biopsy. Other patients were followed-up at 5-17 months. Two cases that received total tumor resection did not have recurrence. In those who received conservative therapy, all hemangiomas disappeared within 1 year. CONCLUSION: The diagnosis of hepatic hemangioma can be made from symptomology, ultrasound, and CT; pathologic samples are not necessary. Corticosteroid therapy is the widely used therapy. Proactive therapy for congestive heart failure is helpful for those endangering liver hemangioma. Surgery can increase the risk of complications and is not advised for treatment of neonatal hepatic hemangioma.