BACKGROUND: The clinical presentation of foetal hepatic haemangioma (HH) is highly variable, from asymptomatic to life-threatening. OBJECTIVE: The aim of this study was to describe foetal hepatic haemangioma and identify prognostic factors. MATERIALS AND METHODS: Antenatal and postnatal imaging studies, clinical and biological records of infants with antenatally diagnosed HH (2001-2009) were reviewed. RESULTS: Sixteen foetuses had one focal lesion, with a mean volume of 75 ml (5-240 ml). One had multifocal HH. Most presented as a focal well-delimited heterogeneous vascular mass. Four had associated cardiomegaly, five had cardiac failure. Eight of the nine foetuses with cardiac disorders were symptomatic at birth: cardiac failure with pulmonary hypertension (9), consumptive coagulopathy (8), compartmental syndrome (2). All received supportive medical treatment, four embolisation. Five of these died. The remaining eight had a normal cardiac status. Two became symptomatic after birth: one with a large porto-hepatic shunt and one with significant mass effect. Prenatal cardiac abnormality (univariate, P = 0.031), enlargement of more than one hepatic vein (P = 0.0351) and large volume (P = 0.0372) were associated with symptomatic disease. CONCLUSION: Hepatic haemangioma associated with prenatal cardiac disorders, large volume and more than one enlarged hepatic vein have poorer outcome and require specific perinatal multidisciplinary management.
BACKGROUND: The clinical presentation of foetal hepatic haemangioma (HH) is highly variable, from asymptomatic to life-threatening. OBJECTIVE: The aim of this study was to describe foetal hepatic haemangioma and identify prognostic factors. MATERIALS AND METHODS: Antenatal and postnatal imaging studies, clinical and biological records of infants with antenatally diagnosed HH (2001-2009) were reviewed. RESULTS: Sixteen foetuses had one focal lesion, with a mean volume of 75 ml (5-240 ml). One had multifocal HH. Most presented as a focal well-delimited heterogeneous vascular mass. Four had associated cardiomegaly, five had cardiac failure. Eight of the nine foetuses with cardiac disorders were symptomatic at birth: cardiac failure with pulmonary hypertension (9), consumptive coagulopathy (8), compartmental syndrome (2). All received supportive medical treatment, four embolisation. Five of these died. The remaining eight had a normal cardiac status. Two became symptomatic after birth: one with a large porto-hepatic shunt and one with significant mass effect. Prenatal cardiac abnormality (univariate, P = 0.031), enlargement of more than one hepatic vein (P = 0.0351) and large volume (P = 0.0372) were associated with symptomatic disease. CONCLUSION:Hepatic haemangioma associated with prenatal cardiac disorders, large volume and more than one enlarged hepatic vein have poorer outcome and require specific perinatal multidisciplinary management.
Authors: Emily R Christison-Lagay; Patricia E Burrows; Ahmad Alomari; Josée Dubois; Harry P Kozakewich; Tricia S Lane; Harriet J Paltiel; Giannoula Klement; John B Mulliken; Steven J Fishman Journal: J Pediatr Surg Date: 2007-01 Impact factor: 2.545
Authors: Christine Léauté-Labrèze; Eric Dumas de la Roque; Thomas Hubiche; Franck Boralevi; Jean-Benoît Thambo; Alain Taïeb Journal: N Engl J Med Date: 2008-06-12 Impact factor: 91.245
Authors: G Mari; R L Deter; R L Carpenter; F Rahman; R Zimmerman; K J Moise; K F Dorman; A Ludomirsky; R Gonzalez; R Gomez; U Oz; L Detti; J A Copel; R Bahado-Singh; S Berry; J Martinez-Poyer; S C Blackwell Journal: N Engl J Med Date: 2000-01-06 Impact factor: 91.245
Authors: X Capelle; P Syrios; F Chantraine; V Rigo; J-P Schaaps; F Kridelka; J-M Foidart Journal: J Gynecol Obstet Biol Reprod (Paris) Date: 2009-03-19