Catastrophic congenital hemangioma with severe coagulopathy leading to fatal cardiac failure: Case report and review

Sally Cohen-Cutler; Linda J Szymanski; Crystal Bockoven; Joseph M Miller; Diana Moke; Dean M Anselmo; Jessica Lee; Minnelly Luu

doi:10.1111/pde.14825

Catastrophic congenital hemangioma with severe coagulopathy leading to fatal cardiac failure: Case report and review

Pediatr Dermatol. 2021 Sep;38(5):1276-1282. doi: 10.1111/pde.14825. Epub 2021 Sep 30.

Authors

Sally Cohen-Cutler^{1

2}, Linda J Szymanski^{2

3}, Crystal Bockoven³, Joseph M Miller^{2

4}, Diana Moke^{1

2}, Dean M Anselmo^{2

5}, Jessica Lee^{2

6}, Minnelly Luu^{2

7}

Affiliations

¹ Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
² Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Department of Anatomic Pathology, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁴ Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁵ Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁶ Division of Pediatric Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁷ Department of Dermatology, Children's Hospital Los Angeles, Los Angeles, CA, USA.

PMID: 34595775
DOI: 10.1111/pde.14825

Abstract

We present a complex case of a neonate, delivered urgently for hydrops fetalis, with a large vascular mass of the extremity, diagnosed postnatally as a congenital hemangioma. The patient suffered immediate cardiac compromise and severe coagulopathy atypical for the diagnosis and subsequently died from these complications. Treatment was imperative but challenging due to a lack of a standardized treatment approach and few historical reports of equally critically ill patients. In this report, we review potential medical and surgical interventions and discuss treatment considerations in similar, life-threatening cases of congenital hemangiomas.

Keywords: hemangiomas/vascular tumors; neonatal; therapy-systemic; vascular malformation.

Publication types

Case Reports
Review

MeSH terms

Heart Failure* / etiology
Hemangioma* / complications
Hemangioma* / diagnosis
Humans
Hydrops Fetalis
Infant, Newborn