Infantile hepatic hemangioendothelioma presenting as early heart failure: report of two cases.

Hepatic hemangioendothelioma is rare. We report on hepatic hemangioendotheliomas in 2 young infants, with initial manifestations of respiratory distress and congestive heart failure. Serum alpha-fetoprotein (alphaFP) level was as high as 26,343 microg/l at 14 days old in 1 case, but was only 18 microg/l in the other case. The 2 patients were treated with prednisolone and hepatic artery ligation, respectively, with no residual sequelae after 12 months of follow-up. In this article, the clinical courses of these 2 young infants are reviewed, and the management of infantile hepatic hemangioendothelioma complicated with heart failure is discussed. In our experience, early heart failure caused by infantile hepatic hemangioendothelioma can be well controlled, especially with prednisolone therapy or by hepatic artery ligation. Spontaneous regression has been reported. However, without early recognition and therapeutic intervention, progression to decompensated heart failure may lead to death. Furthermore, it is necessary to differentiate infantile hepatic hemangioendothelioma (IHH) from hepatic malignancies.