Discussion of Infantile hemangioendothelioma
- Infantile hemangioendotheliomas are liver lesions composed of large endothelial-lined vascular channels
- Histologically distinct from hemangioma.
- Hemangioendotheliomas have been detected in utero as early as 16 weeks gestation.
- Substantial arteriovenous shunting may lead to fetal cardiovascular compromise and hydrops.
- In addition, fetuses may also develop hemolytic anemia, thrombocytopenia, and consumptive coagulopathy (Kasabach-Merritt sequence).
- If these tumors are not detected prenatally, neonates may present with unexplained congestive heart failure.
- The natural history of hemangioendotheliomas in infancy is a rapid, proliferative growth phase in the first 6 months of life, followed by regression and involution.
- If the child remains asymptomatic, no treatment may be needed.
- If symptoms occur, the first line of treatment is corticosteroids, which are thought to cause vasoconstriction of the aberrant vessels.
 Imaging Findings for Infantile hemangioendothelioma
- Infantile hemangioendotheliomas have a variable sonographic appearance and may be either hypoechoic or hyperechoic or may have mixed echogenicity.
- Color Doppler US evaluation will show increased flow.
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 References for Infantile hemangioendothelioma
- Paula J. Woodward, Roya Sohaey, Anne Kennedy, and Kelly K. Koeller. From the Archives of the AFIP: A Comprehensive Review of Fetal Tumors with Pathologic Correlation. RadioGraphics 2005 25: 215-242.