Surgical management of large scalp infantile hemangioma in 30-month-old infant


Submitted: 17 November 2021
Accepted: 8 March 2022
Published: 21 March 2022
Abstract Views: 1635
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Authors

  • Cosimo Bleve Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza;, Italy.
  • Maria Luisa Conighi Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy.
  • Enrico Valerio Neonatal Intensive Care Unit, Department of Woman and Child’s Health, University of Padova, Italy.
  • Mario Cutrone Women and Child’s Health Department, Pediatric and Neonatal Intensive Care Unit, San Bortolo Hospital, Vicenza, Italy.
  • Giuseppe Iannucci Department of Neuroradiology, San Bortolo Hospital, Vicenza, Italy.
  • Alessandro Segna Department of Neuroscience and Neurosurgery, San Bortolo Hospital, Vicenza, Italy.
  • Salvatore Fabio Chiarenza Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy. https://orcid.org/0000-0001-7822-2963

Infantile Hemangiomas (IH) are the most common benign tumor of infancy, occurring in over 10% of newborns. The head and neck is the most frequently affected area (60%), and the scalp is a typical site for such large lesions. Scalp-IHs are usually focal lesions that can be both disfiguring and may lead to complications such as ulceration and bleeding. We describe a case of a 30-months old female who presented a large scalp-IH at birth that rapidly grew in the first year of life. Topical and systemic treatments (with timolol ointment and oral propranolol, respectively) were not effective in reducing dimensions of the hemangioma. After vascular imaging study, the patient underwent surgical resection of the IH and primary closure with excellent cosmetic outcome. When medical therapy is ineffective or cosmetic and functional integrity is threatened, early surgery allows to completely removing large scalp-IHs, with good cosmetic results.


Chang LC, Haggstrom AN, Drolet BA, et al. Growth characteristics of infantile hemangiomas: implications for management. Pediatrics 2008;122:360–367 DOI: https://doi.org/10.1542/peds.2007-2767

Spector JA, Blei F, Zide BM. Early surgical intervention for proliferating hemangiomas of the scalp: indications and outcomes. Plast Reconstr Surg 2008;122:457–62. DOI: https://doi.org/10.1097/PRS.0b013e31817d5fa2

Zhu Z, Yang X, Zhao Y, et al. Early surgical management of large scalp infantile hemangioma using the TopClosure® tension-relief system. Medicine 2015;94:e2128. DOI: https://doi.org/10.1097/MD.0000000000002128

Maguiness SM, Frieden IJ. Management of difficult infantile haemangiomas. Arch Dis Child 2012;97:266–271. DOI: https://doi.org/10.1136/archdischild-2011-300851

Cho YK, Ryu DW, Chung HY, et al. Surgical management of scalp infantile hemangiomas. J Craniofac Surg 2015;26:1169–72 DOI: https://doi.org/10.1097/SCS.0000000000001561

Drolet BA, Frommelt PC, Chamlin SL, et al. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics 2013;131:128-40. DOI: https://doi.org/10.1542/peds.2012-1691

Haggstrom AN, Drolet BA, Baselga E, et al. Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment. Pediatrics 2006;118:882–7. DOI: https://doi.org/10.1542/peds.2006-0413

Marey HM, Elmazar HF, Mandour SS, Khairy HA. Combined oral and topical beta blockers for the treatment of early proliferative superficial periocular infantile capillary hemangioma. J Pediatr Ophthalmol Strabismus 2018;55:37-42. DOI: https://doi.org/10.3928/01913913-20170703-12

Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, et al. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med 2015;372:735-46. DOI: https://doi.org/10.1056/NEJMoa1404710

Santecchia L, Valassina MFB, Maggiulli F, et al. Early surgical excision of giant congenital hemangiomas of the scalp in newborns: Clinical indications and reconstructive aspects. J Cutan Med Surg 2013;17:106–13. DOI: https://doi.org/10.2310/7750.2012.11113

Hayashi T, Ishibashi A, Hashimoto T, et al. Huge congenital angioma of the scalp. A case report. Kurume Med J 1981;28:91–4. DOI: https://doi.org/10.2739/kurumemedj.28.91

Alluhaybi AA, Abdulqader SB, Altuhayni K, et al. Preoperative trans-arterial embolization of a giant scalp congenital hemangioma associated with cardiac failure in a premature newborn. J Int Med Res 2020;12:1-7. DOI: https://doi.org/10.1177/0300060520977589

Supporting Agencies

Infantile hemangioma; Surgical management, Magnetic Resonance Imaging Propranolol, Scalp.

Bleve, C., Conighi, M. L., Valerio, E., Cutrone, M. ., Iannucci, G., Segna, A., & Chiarenza, S. F. (2022). Surgical management of large scalp infantile hemangioma in 30-month-old infant. La Pediatria Medica E Chirurgica, 44(1). https://doi.org/10.4081/pmc.2022.279

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