RESUMO
INTRODUCTION: Infantile hepatic hemangioma with consumptive hypothyroidism is a rare condition. CASE REPORT: A 4-month-old girl presented with diffuse hepatic hemangiomas during treatment of congenital hypothyroidism. Serum reverse triiodothyronine was elevated, and her hypothyroidism improved concomitant with involution of the hemangioma following prednisolone and interferon-alpha administration. At 20 months of age, 7 months after discontinuing prednisolone and interferon-alpha, a focal hemangioma regrew from one of the previous lesions and was surgically resected. The expression and activity of type 3 iodothyronine deiodinase (D3) were elevated in the resected tumor tissue compared with placenta. DISCUSSION: Here, we describe a patient with consumptive hypothyroidism and diffuse infantile hepatic hemangiomas, one of which regrew after involution following pharmacotherapy. The etiology of elevated D3 activity is also discussed. CONCLUSION: It is important to identify infantile hepatic hemangioma in patients with hypothyroidism refractory to hormone replacement therapy, who have low free triiodothyronine despite high thyrotropin and normal free thyroxine levels, and long-term follow-up will be needed for these patients.
Assuntos
Hemangioma/enzimologia , Hipotireoidismo/complicações , Iodeto Peroxidase/metabolismo , Neoplasias Hepáticas/enzimologia , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Diagnóstico Diferencial , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Hemangioma/complicações , Hemangioma/diagnóstico , Humanos , Hipotireoidismo/enzimologia , Lactente , Iodeto Peroxidase/genética , Fígado/metabolismo , Fígado/patologia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Imageamento por Ressonância Magnética , Reação em Cadeia da Polimerase , RNA Neoplásico/genética , Fatores de TempoRESUMO
The use of memory metallic stents for the urinary tract in pediatric patients has not been reported. The authors report on 2 patients with urinary tract disorders who were successfully treated with a memory metallic stent. A thermoexpandable, nickel-titanium alloy stent was placed at the urethroureteral junction of a 4-year-old boy with ureteral stenosis associated with cloacal exstrophy for 18 months and at the urethra of a 2-year-old girl with ischuria after a repair of cloacal anomaly for 6 months. Temporary insertion of a memory metallic stent is a safe and effective alternative for organic stricture or functional obstruction of the urinary tract in pediatric patients.
