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Tan X, Liu Z, Zhou S, Chen K, Zhang M, Xia J, Guo Y, Zhou Z. Analysis of angiographic characteristics of kaposiform hemangioendothelioma and investigation of the value of transcatheter arterial embolization therapy. Transl Pediatr 2021; 10:3194-3201. [PMID: 35070833 PMCID: PMC8753462 DOI: 10.21037/tp-21-486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to analyze the angiographic characteristics of kaposiform hemangioendothelioma (KHE) and investigate the value of transcatheter arterial embolization (TAE) therapy. METHODS The clinical data of infants diagnosed with KHE at the department from June 2013 to June 2020 were retrospectively analyzed. Of these, 34 infants received TAE therapy. The efficacy of the treatment was evaluated 4 weeks after the therapy. The angiographic characteristics were analyzed by comparing them with the angiographic characteristics of infantile hemangioma (IH), and the times of TAE therapy and the platelet level after each TAE therapy in infants with KHE were summarized. RESULTS The present study showed that the capillary blush of KHE was irregular with an obscure boundary and nonuniform distribution. Many fine feeding arteries were present. The diameter of the feeding arteries was disproportionate to the volume of the tumor blush. The normal arteries were usually embedded in the tumor blush. The angiography of common IH in infants also showed tumor blush, but it was usually round with a clear boundary and uniform staining, and was distributed on 1 side of the normal arterial trunk. The infants with KHE received TAE therapy for 2 to 5 times/case, with a total of 104.0 times, with an average of 3.1±0.8/case. Among which, the platelets continued to decline for 9 times after TAE therapy and the platelets increased to ≥100×109/L in 7.8±3.2 days for 95 times after TAE therapy, The average relapse time was 30.0±15.9 days. CONCLUSIONS The feeding arteries of KHE were numerous and fine and were not easily embolized. The application of TAE may rapidly improve the platelet level, but the long-term effect is poor.
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Affiliation(s)
- Xiaoyun Tan
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Zhenyin Liu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Shaoyi Zhou
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Kunshan Chen
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ming Zhang
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jiejun Xia
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yiqun Guo
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Zijun Zhou
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Interventional Therapy and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou, China
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Successful Management of Kaposiform Hemangioendothelioma with Long-Term Sirolimus Treatment: a Case Report and Review of the Literature. Mediterr J Hematol Infect Dis 2018; 10:e2018043. [PMID: 30002799 PMCID: PMC6039087 DOI: 10.4084/mjhid.2018.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/15/2018] [Indexed: 12/04/2022] Open
Abstract
Background Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumour of the infancy and the first decade of life. It is locally aggressive and potentially life threatening when associated with consumptive coagulopathy, known as Kasabach-Merritt syndrome (KMS). No consensus or guideline for the therapy has been reached because of the lack of prospective trials, and the different standard care suggestions are based on retrospective case series. Case report We report the case of a 9-month-old male with KHE and KMS in which the initial response, obtained with prednisone and vincristine, was subsequently consolidated and strengthened by long-term treatment with sirolimus, a mTOR inhibitor. A summary of the published data is presented as well. Conclusions The inhibition of mTOR pathway represents the most important therapeutic innovation introduced in the last few years for KHE. Our case shows the effectiveness and good tolerance of long-term therapy with sirolimus.
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Guo X, Gong Y, Dong C. Surgical treatment of a huge kaposiform hemangioendothelioma in the chest wall: A case study. SAGE Open Med Case Rep 2017; 4:2050313X16684742. [PMID: 28228957 PMCID: PMC5308515 DOI: 10.1177/2050313x16684742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/21/2016] [Indexed: 12/02/2022] Open
Abstract
Kaposiform hemangioendothelioma, a rare vascular pediatric tumor often associated with Kasabach–Merritt phenomenon, is characterized by severe thrombocytopenia and consumptive coagulopathy. Kaposiform hemangioendothelioma is a severe disease and may progress quickly, resulting in a high mortality. However, standard treatment regimens for Kasabach–Merritt phenomenon have not yet been established. We reported here an infant with a large congenital kaposiform hemangioendothelioma in his chest wall who responded extremely well to surgical excision.
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Affiliation(s)
- Xiaonan Guo
- Department of Hemangioma & Vascular Malformation, Henan Provincial People's Hospital, Zhengzhou, P.R. China
| | - Yubin Gong
- Department of Hemangioma & Vascular Malformation, Henan Provincial People's Hospital, Zhengzhou, P.R. China
| | - Changxian Dong
- Department of Hemangioma & Vascular Malformation, Henan Provincial People's Hospital, Zhengzhou, P.R. China
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Pascal S, Bettex Q, Andre N, Petit P, Casanova D, Degardin N. Successful surgical management of congenital Kasabach-Merritt syndrome. Pediatr Int 2017; 59:89-92. [PMID: 28102622 DOI: 10.1111/ped.13171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 06/08/2016] [Accepted: 07/29/2016] [Indexed: 12/24/2022]
Abstract
Since the first description of Kasabach-Merritt syndrome (KMS) in 1940, many treatments have been proposed combining pharmacologic and non-pharmacologic approaches, which can be effective on the pathology but can have adverse and unpredictable side-effects with long-term use. Herein we describe the solely surgical treatment of Kasabach-Merritt syndrome in a neonate with a severe and rapidly progressive thrombocytopenia. The patient's condition normalized at 7 days postoperatively, with rapid increase in platelet count and normalization of d-dimer concentration.
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Affiliation(s)
- Sébastien Pascal
- Pediatric Plastic Surgery Department, Timone Enfants University Hospital, Marseille, France
| | - Quentin Bettex
- Pediatric Plastic Surgery Department, Timone Enfants University Hospital, Marseille, France
| | - Nicolas Andre
- Pediatric Oncology Department, Timone Enfants University Hospital, Marseille, France
| | - Philippe Petit
- Pediatric Imaging Department, Timone Enfants University Hospital, Marseille, France
| | | | - Nathalie Degardin
- Pediatric Plastic Surgery Department, Timone Enfants University Hospital, Marseille, France
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Tan X, Chen M, Zhang J, Zhou S, Shen G, Liu Z, Jiang H, Xia J. Treatment of Corticosteroid-Resistant Vascular Tumors Associated with the Kasabach-Merritt Phenomenon in Infants: An Approach with Transcatheter Arterial Embolization Plus Vincristine Therapy. J Vasc Interv Radiol 2016; 27:569-75. [DOI: 10.1016/j.jvir.2015.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/11/2015] [Accepted: 12/12/2015] [Indexed: 11/17/2022] Open
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Lee JW, Jung HL, Shim JW, Kim DS, Shim JY, Park MS, Park HJ. A Case of Kasabach-Merritt Syndrome Successfully Treated with Interferon-alpha 2b and Propranolol. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2015. [DOI: 10.15264/cpho.2015.22.2.161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Jung-Won Lee
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Won Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Deok Soo Kim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Soo Park
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Blei F. Update June 2014. Lymphat Res Biol 2014. [DOI: 10.1089/lrb.2014.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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