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      Diffuse hepatic hemangioma with single cutaneous hemangioma: an alerting occurrence

      case-report

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          Key Clinical Message

          Screening of infants with five or more cutaneous infantile hemangiomas with abdominal ultrasound is often recommended. However, diffuse hepatic hemangioma can develop even in patients with single cutaneous hemangioma. This highlights the importance of physical examination and screening ultrasound in these patients.

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          Most cited references12

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          Propranolol for infantile haemangiomas: insights into the molecular mechanisms of action.

          Infantile haemangiomas (IH) are the most common benign tumours of infancy. Although most IH are innocuous and 85-90% regress spontaneously, some may become life- or function-threatening and require immediate treatment. Previous standard therapeutic options include physical measures (laser surgery, cryosurgery) and systemic corticosteroids, in severe cases also vincristine, alpha-interferon or cyclophosphamide, all bearing the risk of serious side-effects. Oral propranolol is a very recent therapeutic option for complicated IH with impressive efficacy and generally good tolerance. The effects of propranolol on IH were discovered by chance, and very little is known about its mechanisms of action in IH. Here we present a summary of current knowledge of how propranolol interferes with endothelial cells, vascular tone, angiogenesis and apoptosis. Early, intermediate and long-term effects of propranolol on IH can be attributed to three different pharmacological targets. Early effects (brightening of the haemangioma surface within 1-3 days after start of therapy) are attributable to vasoconstriction due to decreased release of nitric oxide. Intermediate effects are due to the blocking of proangiogenic signals (vascular endothelial growth factor, basic fibroblast growth factor, matrix metalloproteinase 2/9) and result in growth arrest. Long-term effects of propranolol are characterized by induction of apoptosis in proliferating endothelial cells, and result in tumour regression.
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            Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas.

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              Hepatic haemangioma: common and uncommon imaging features.

              The haemangioma, the most common non-cystic hepatic lesion, most often discovered by chance, may in certain situations raise diagnostic problems in imaging. In this article, the authors first demonstrate that the radiological appearance of the hepatic haemangioma, in its typical form, is closely related to three known histological sub-types. They then show that certain atypical features should be known in order to establish a diagnosis. They also observe the potential interactions between the haemangioma, an active vascular lesion, and the adjacent hepatic parenchyma. Finally, they discuss the specific paediatric features of hepatic haemangiomas and illustrate the case of a hepatic angiosarcoma.
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                Author and article information

                Contributors
                nahidarif@yahoo.fr
                Journal
                Clin Case Rep
                Clin Case Rep
                10.1002/(ISSN)2050-0904
                CCR3
                Clinical Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2050-0904
                24 April 2017
                June 2017
                : 5
                : 6 ( doiID: 10.1002/ccr3.2017.5.issue-6 )
                : 887-890
                Affiliations
                [ 1 ] Department of PediatricsMakassed General Hospital BeirutLebanon
                [ 2 ] Department of RadiologyMakassed General Hospital BeirutLebanon
                [ 3 ]Dr Anoir Abdel Khalek Center of Radiology BeirutLebanon
                Author notes
                [*] [* ] Correspondence

                Nahida El‐Rifai, Department of Pediatrics, Makassed General Hospital, 11‐6301 Riyadh El Solh Street, Beirut, Lebanon. Tel: 00961 3 082988; Fax: 009611646589; E‐mail: nahidarif@ 123456yahoo.fr

                Author information
                http://orcid.org/0000-0002-4531-3532
                Article
                CCR3963
                10.1002/ccr3.963
                5457989
                28588832
                ed84a342-9c66-47f9-893b-999825db25ee
                © 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 January 2017
                : 12 March 2017
                Page count
                Figures: 3, Tables: 0, Pages: 4, Words: 2225
                Categories
                Case Report
                Case Reports
                Custom metadata
                2.0
                ccr3963
                June 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.0 mode:remove_FC converted:05.06.2017

                consumptive hypothyroidism,cutaneous hemangioma,hepatic hemangioma,infant

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