Rapidly Involuting Congenital Hemangioma: Five Case Reports / 대한피부과학회지

Rapidly involuting congenital hemangioma (RICH), a subtype of congenital hemangioma (CH), is fully developed at birth and undergoes rapid involution by 6–14 months of age. Clinically, this vascular lesion differs from both non-involuting CH and infantile hemangiomas. It is important to distinguish between this rare condition and other vascular lesions to ensure appropriate management (active intervention vs. non-intervention). We describe 5 patients diagnosed with RICH based on clinicopathological and/or imaging studies. Three patients showed red-stippled bluish to purplish tense plaques and two showed slightly depressed red-stippled hypopigmented rubbery patches at their initial visit. Spontaneous involution commenced shortly after birth, and complete involution occurred by 16.0±9.9 months of age. Doppler ultrasonography and magnetic resonance imaging were performed for further evaluation. Histopathological examination revealed vascular lobules of various sizes without true arteriovenous microfistulae, and thickened intra- and interlobular vessels were prominent with glucose transporter isoform-1 protein negativity.

Neonatal RICH associated with thrombocytopenia and coagulopathy: a case report and literature review / 中华整形外科杂志

We treated a neonate who was diagnosed as rapidly involuting congenital hemangioma (RICH). With a review on the clinical manifestation, differential diagnosis, and treatment of RICH that associated with thrombocytopenia(TP)and coagulopathy(CP)and received platelet transfusions and embolization therapy including absolute ethanol and polidocanol in our hospital in March of 2015. The platelets and coagulation function soon returned to normal, the tumor involuted significantly. Surgical excision was proceeded subsequently. The platelets returned to normal level after a one-time platelet transfusion, meanwhile, multiple reexaminations of blood coagulation function were normal. Postoperatively, incision wound healed well. There was no recurrence, and the functional recovery of upper limb was satisfactory. RICH is a rare type of vascular tumor which may present with TP and CP similar to KHE-KMP in the neonatal period. More attention should be addressed to identify these two diseases, because the treatment and prognosis of which have significant differences. Consumption of coagulation factors with milder platelet decrease may also be a complication of slow flow venous or venolymphatic malformations.

Two Cases of Congenital Hemangioma / 대한피부과학회지

Congenital hemangioma (CH) is a fully formed benign vascular tumor at the time of birth and do not proliferate in postnatal life. CH must be differentiated from infantile hemangioma. CH has three subtypes that are recognized based on their natural history: Rapidly involuting congenital hemangioma (RICH), non-involuting congenital hemangioma (NICH), and partially involuting congenital hemangioma (PICH). It is important to distinguish RICH from NICH because RICH spontaneously regresses but NICH does not. Herein, we report two patients diagnosed with RICH and NICH, respectively. We presented the clinical features as well as ultrasonographic and histologic findings to distinguish congenital from infantile hemangioma.