[Place of the precocious surgical treatment in facial hemangioma]

Infantile cutaneous hemangioma is a benign vascular tumour present in 10%of the infants. It is part of the group of the vascular tumours in the classification of International Society for Vascular Anomalies [ISSVA]. Usual surgical attitude is abstention and surgery is proposed only in order to treat sequelae. But some particular situations require early surgery to avoid functional impairment, deformation or growth delay due to the lesion's development. Using our observations, we recall the epidemiology, the physiopathology, the clinical aspects, the particularities of the facial localizations and their treatments. In these localizations the time intervenes like a 4th dimension that is going to modify, to improve or to aggravate the prognosis. Treatment requires a strategy and precocious surgery. We insist on the fact that the dogma of the therapeutic abstention remains true for a majority of children with small size hemangiorma and that a precocious surgery must be proposed for some localizations in the face

Precocious puberty and hypothalamic hamartoma

Central precocious puberty is exceptionally due to hypothalamic hamartoma in girls under one year of age. A small girl hospitalized for exploration of precocious puberty started since the age of 7 months. Exploration of the hypothalamic-pituitary axis confirmed the central origin of this puberty. Magnetic resonance imaging [MRI] showed a small pediculate hypothalamic hamartoma [HH]. Evolution under triptorelin [recoil of 6 years] was favourable with notably the secondary sexual characters disappearance, the slowing of the speed of growth and the bony maturation. Central precocious puberty must make search HH even in girl. Its pathogenesis again controversial, seem to be in this age probably multifactorial. Our observation illustrates the efficiency of long-acting GnRH agonists during the central precocious puberty due to HH even in infantile form