Infantile hepatic hemangioma: current state of the art, controversies, and perspectives

Eur J Pediatr. 2020 Jan;179(1):1-8. doi: 10.1007/s00431-019-03504-7. Epub 2019 Nov 22.

Abstract

Infantile hepatic hemangioma (IHH) is a common vascular tumor, distinctive for its perinatal presentation, rapid growth during the first year of life, and subsequent involution. Although they generally follow a benign course, some tumors have been reported to undergo malignant transformation. The diagnosis of IHH is based on patient's medical history, physical examination, and imaging. Moreover, the management of this vascular tumor is based on clinical presentation and includes observational, medical, surgical, and radiological interventional treatment options. The present review presents the currently available data in the literature on the diverse aspects of the terminology, epidemiology, clinical presentation, pathogenesis, diagnosis, indications for surgery, malignant potential, and long-term outcomes of these tumors.Conclusion: No formal guidelines have yet been established for the treatment of these hepatic lesions, and the therapeutic strategies implemented vary widely from simple observation to medical, radiological, and surgical interventions in the prism of multidisciplinary teams.What is Known:• Infantile hepatic hemangioma is the most common benign tumor of the liver in infancy, but despite its benign nature, it can present with life-threatening complications.• The treatment strategies range from simple observation to a series of medical, surgical, and radiological interventions.What is New:• This review gives an overview of the developments and current status about the management of IHH.• The aim of this study is to clear up the confusion and controversy that exists about terminology, diagnosis, and treatment of IHH.

Keywords: Diagnosis; Infantile hepatic hemangioma; Management; Vascular tumor.

Publication types

  • Review

MeSH terms

  • Child
  • Child Health
  • Child, Preschool
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Global Health
  • Hemangioma* / diagnosis
  • Hemangioma* / epidemiology
  • Hemangioma* / etiology
  • Hemangioma* / therapy
  • Humans
  • Infant
  • Infant, Newborn
  • Liver Neoplasms* / diagnosis
  • Liver Neoplasms* / epidemiology
  • Liver Neoplasms* / etiology
  • Liver Neoplasms* / therapy
  • Prognosis