A 2-month-old female patient presented an extensive bilateral parotid
hemangioma (PH) focally ulcerated. Additionally, hepatic ultrasonography revealed a
hemangioendothelioma located at right lobe. She was treated with oral
prednisolone (3 mg/kg/day) during 10 months with clinical improvement of PH, despite
failure to thrive and arterial
hypertension. However, regrowth of the lesion occurred after discontinuation of oral
steroid.
Propranolol hydrochloride (2 mg/kg/day divided into two doses) was then started and maintained for 16 months, with marked involution of the
hemangioma and with no systemic side effects during treatment course. Curiously, also the liver
hemangioendothelioma completely resolved after starting
propranolol. PH is a threatening cervicofacial segmental
hemangioma that frequently proliferates after the year of age and needs long-term treatment. On the other hand, hepatic
hemangioendotheliomas may be associated with cutaneous
hemangiomas in some patients and their natural history is similar to these, although patients may die of associated conditions. As for other infantile
hemangiomas,
propranolol proved to be an effective, safe, and well-tolerated treatment for PH. Its role in liver
hemangiomas and
hemangioendotheliomas should also be taken into account.