Blood-vessel neoplasms in children: epidemiologic aspects.

In a search for etiologic leads to blood-vessel neoplasms, we examined 111 death certificates of U.S. children who died from 1960 to 1968 of angiosarcoma, hemangioendothelioma, and hemangiopericytoma and 127 medical records of similar cases from 12 institutes. The available data provided no leads to environmental agents (vinyl chloride, thorotrast, arsenic) that can produce vascular liver tumors in adults, but one infant, who died from a hepatic tumor, lived within a mile of an industrial source of polyvinyl chloride. About half of the children with hepatic hemangioendotheliomas had associated skin hemangiomas, which may aid in the differential diagnosis of liver tumors in infancy. Hepatic hemangioendotheliomas also predominated in girls, a possible clue to the origin of the tumor. A familial influence was suggested by one sibling aggregation of cutaneous hemangioendotheliomas.