If a child presents with recurrent stridor, or stridor when it is not croup season, a subglottic hemangioma should be suspected, Dr. Blei stated. Croup can be treated with a short course oral of steroids and the stridor may resolve for a short period of time, but a recurrence suggests that an airway hemangioma is present. Subglottic hemangiomas are treated with oral steroids and laser surgery; in some cases, laser can avoid the need for steroids. Tracheotomy may be required if steroids are ineffective and the child is in extremis, Dr. Blei said.
Not all large facial hemangiomas will have accompanying anomalies; in fact, large facial hemangiomas without anomalies are probably more common that those associated with PHACES. – -Denise Metry, MD
Unusual or large hemangiomas on the face may be associated with failure to thrive syndrome. Dr. Blei said that children with very large hemangiomas having increased blood flow can have cardiac problems and should be referred to a cardiologist for evaluation. In general, any patient with a complicated hemangioma should be referred to a vascular anomalies center for a treatment plan, which can then be carried out in conjunction with the child’s local doctor.| ← Previous | | | Next → | Single Page