Hepatic Kaposiform hemangioendothelioma in a newborn: case report

Authors

  • D.S. Diehtiarova Bogomolets National Medical University, Ukraine
  • I.M. Benzar Bogomolets National Medical University; National Children’s Specialized Hospital «OKHMATDYT», Ukraine
  • O.S. Godik Bogomolets National Medical University; National Children’s Specialized Hospital «OKHMATDYT»,
  • S.O. Rebenkov National Children’s Specialized Hospital «OKHMATDYT», Ukraine

DOI:

https://doi.org/10.15574/PS.2020.67.78

Keywords:

Kaposiform hemangioendothelioma, newborns, vincristine, liver resection

Abstract

According to updated ISSVA 2018 classification, kaposiform hemangioendothelioma (KHE) is related to locally aggressive tumors. In most cases – approximately in 79%, the first clinical signs appear in neonatal period. When located in liver, this symptomatic tumor tends to clinically-cacoethic presentation with life threatening complications development and high death rate. Among such complications Kasabach–Meritt syndrome, intraabdominal bleedings, cardiac failure, and respiratory disorders should be mentioned. Numerous treatment options of KHE and its complications are being used, but no standardized approach exists. To verify the final diagnosis immunohistochemical analysis of tumor tissues must be performed for endothelium proliferation markers, such as CD-31 and CD-34. Differential diagnosis of hepatic vascular tumors is complicated because the biopsy is not performed in general, as there is a high risk of massive bleeding or uncontrolled tumor growth provocation. The success of KHE treatment depends on pediatric surgeons’, pediatricians’, and neonatologists’ knowledge on this pathology, on careful analysis of clinical presentation and diagnostic findings, especially of imaging methods like computer tomography (CT) or magnetic-resonance imaging (MRI). The article highlights the clinical case of complex treatment of hepatic Kaposiform hemangioendothelioma in a newborn with vincristine administration, that allowed to perform the surgical resection of vascular tumor. The current state literature review is presented.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies.

 

References

Chinello M, Di Carlo D, Olivieri F et al. (2018). Successful management of Kaposiform Hemangioendothelioma with long-term sirolimus treatment: a case report and review of the literature. Mediterranean Journal of Hematology and Infectious Diseases. 10 (1). 2018043. https://doi.org/10.4084/mjhid.2018.043; PMid:30002799 PMCid:PMC6039087.

Croteau SE, Liang MG, Kozakewich HP, Alomari AI, Fishman SJ, Mulliken JB et al. (2013). Kaposiform hemangioendothelioma: atypical features and risks of Kasabach-Merritt phenomenon in 107 referrals. J Pediatr.162 (1):142–147. https://doi.org/10.1016/j.jpeds.2012.06.044; PMid:22871490 PMCid:PMC3494787.

Drolet BA, Trenor CC 3rd, Brandao LR et al. (2013, Jul). Consensus-derived practice standards plan for complicated Kaposiform hemangioendothelioma. JPediatr. 163 (1): 285–291. https://doi.org/10.1016/j.jpeds.2013.03.080; PMid:23796341.

Gang MH, Lim YJ., Chang M., (2020). Successful Management of Visceral Kaposiform Hemangioendothelioma with Kasabach–Merritt Phenomenon Using Corticosteroids and Vincristine. Neonatal Medicine.1: 37–43. https://doi.org/10.5385/nm.2020.27.1.37.

Garcia-Monaco R, Giachetti A, Peralta O, Napoli N, Lobos P et al. (2011). Kaposiform Hemangioendothelioma with Kasabach-Merritt Phenomenon: Successful Treatment with Embolization and Vincristine in Two Newborns. Journal of Vascular and Interventional Radiology. 23 (3): 417–422. https://doi.org/10.1016/j.jvir.2011.12.007; PMid:22365299

Gruman A, Liang MG, Mulliken JB, Fishman SJ, Burrows PE, Kozakewich HPW et al. (2005). Kaposiform hemangioendothelioma without Kasabach-Merritt phenomenon. J Am Acad Dermatol. 52 (4): 616–622. https://doi.org/10.1016/j.jaad.2004.10.880; PMid:15793511

International Society for Study of Vascular Anomalies official website https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf

Isaacs Jr H. (2007). Fetal and neonatal hepatic tumours. J Pediatr Surg. 42: 1797–1803. https://doi.org/10.1016/j.jpedsurg.2007.07.047; PMid:18022426

Ji Y, Chen S, Yang K, Xia C, Li L. (2020). Kaposiform hemangioendothelioma: current knowledge and future perspectives. Orphanet Journal of Rare Diseases.15(1). https://doi.org/10.1186/s13023-020-1320-1; PMid:32014025 PMCid:PMC6998257

Ji Y, Chen S, Li L, Yang K, Xia C, Li L et al. (2018). Kaposiform hemangioendothelioma without cutaneous involvement. Journal of Cancer Research and Clinical Oncology. 144: 2475–2484. https://doi.org/10.1007/s00432-018-2759-5; PMid:30293120

Ji Y, Yang K, Peng S, Chen S, Xiang B, Xu Z et al. (2018). Kaposiform haemangioendothelioma: clinical features, complications and risk factors for Kasabach-Merritt phenomenon. Br J Dermatol. 179(2): 457–463. https://doi.org/10.1111/bjd.16601; PMid:29603128

Liu Q, Jiang L, Kan Y, Fu F et al. (2015). Clinicopathological features of Kaposiform hemangioendothelioma. International Journal of Clinical and Experimental Pathology. 8(10): 13711–13718. PMCID: PMC4680544

Lyons LL, North PE, Mac-Moune LF, Stoler MH et al. (2004). Kaposiform hemangioendothelioma: a study of 33 cases emphasizing its pathologic, immunophenotypic, and biologic uniqueness from juvenile hemangioma. Am J Surg Pathol. 28(5): 559–568. https://doi.org/10.1097/00000478-200405000-00001; PMid:15105642

Makin E, Davenport M. (2010). Fetal and neonatal liver tumours. Early Human Development. 86(10): 637–642. https://doi.org/10.1016/j.earlhumdev.2010.08.023; PMid:20956063

Moon SB, Kwon HJ, Park KW, Yun WJ, Jung SE. (2009). Clinical experience with infantile hepatic hemangioendothelioma. World J Surg. 33: 597–602. https://doi.org/10.1007/s00268-008-9882-4

Peng S, Yang K, Xu Z, Chen S and Ji Y. (2019). Vincristine and sirolimus in the treatment of kaposiform haemangioendothelioma. Journal of Paediatrics and Child Health. 55(9): 1119-1124. https://doi.org/10.1111/jpc.14370

Schmid I, Klenk AK, Sparber-Sauer M, Koscielniak E, Maxwell R, Haberle B. (2018). Kaposiform hemangioendothelioma in children: a benign vascular tumor with multiple treatment options. World Journal of Pediatrics. 14: 322-329. https://doi.org/10.1007/s12519-018-0171-5; PMid:30054848

Sevinir B, Ozkan TB. (2007). Infantile hepatic hemangioendothelioma: clinical presentation and treatment. Turk J Gastroenterol. 18: 182–187. PMID: 17891692

Slovis T. (2008). Caffey’s pediatric diagnostic imaging, 11th ed. Philadelphia. PA: Mosby Elsevier. ISBN: 978-0-323-04520-9

Von Schweinitz D. (2003). Neonatal liver tumours. Semin Neonatol. 8: 403–10. https://doi.org/10.1016/S1084-2756(03)00092-7

Wang H, Duan Y, Gao Y, Guo X. (2017). Sirolimus for Vincristine-Resistant Kasabach–Merritt Phenomenon: Report of Eight Patients, Pediatric Dermatology. 34(3): 261-265. https://doi.org/10.1111/pde.13077; PMid:28198567

Wang P, Zhou W, Tao L, Zhao N, Chen X-W. (2014). Clinical analysis of kasabach-merritt syndrome in 17 neonates. BMC Pediatrics. 14(1). https://doi.org/10.1186/1471-2431-14-146; PMid:24920221 PMCid:PMC4088914

Wang Z, Li K, Dong K, Xiao X, Zheng S. (2015). Refractory Kasabach–Merritt phenomenon successfully treated with sirolimus, and a minireview of the published work. J Dermatol. 42(4): 401-404. https://doi.org/10.1111/1346-8138.12797

Published

2020-06-30