The behaviour and treatment outcomes of paediatric hemangiomas

Abstract

Aim: Infantile hemangiomas are the most common vascular tumours of infancy, affecting up to 12% of infants by the first year of life. The main aim of this study is to present the best treatment modality based on the behaviour of hemangiomas in paediatric population and their pattern of progression or regression with age and in response to intralesional steroids and sclerosing agents administered, along with the rate of recurrence in cases where surgical intervention was done. Materials and methods: A total of 25 patients were in- cluded in this study based on inclusion and exclusion cri- teria. The injections (Kenacort /Kenalog, as intralesional injection) were administered at monthly intervals and patients were reviewed. Based on the response elicited to this minimally invasive procedure the patients were divided into the following three groups: A-Responders, B-incomplete responders, C-Non-responders. Surgical intervention was taken up in incomplete responders and Non responders with significant aesthetic and functional compromise. Results: Of all lesions only 16% of the cases responded to non-surgical treatment methods, and were further sub- categorised into: Group A (Responders) which comprised of 2 (8%) of the cases, Group B (Incomplete responders) n= 2(8%) and Group C (Non-Responders) n=21 [84%. All patients belonging to group B and C were treated surgically and fairly good prognosis was documented, as amongst 8% (n=2) + 84% (n=21), 87% (n=20) of the patients were completely cured and re- currence due to the presence of residual tumour was noted in only 13% (n=3) of the cases. Conclusion: As the psychological impact of the congeni- tal deformity on patients is generally more detrimental than it is measurable, except for the post-surgical or traumatic deformities in the treatment of medium size tumours the surgical excision seems to be a worthwhile procedure.