Trang-Tiau Wu*, Meng-Cheng Chen, Wei-Chin Chiu

Department of Pediatric Surgery, Chung-Shan Medical & Dental College Hospital, Taichung, Taiwan, Chinese Taipei



Aim: Infantile Hemangioendotheliomas (IHE) are the most common type of hepatic vascular tumors that present in infancy. We reviewed our experience of I H E in terms of diagnosis, differential diagnosis, surgical treatment, and outcome.

Materials and Results: Four infants (2 boys, 2 girls; age ranges: newborn- 2 months) were referred for definitive management from 1991 through 2000. One neonate girl suffered from diffuse neonatal hemangiomatosis over whole body skin surface and exhibited no congestive heart failure and the bilobar multiple nodular lesion of liver underwent spontaneous regression. Another three patients were symptomatic, and the majority required intensive medical therapy because of anemia, thrombocytopenia, respiratory distress and cardiac failure. All of three symptomatic patients were treated by partial hepatectomy (L't hepatic lobe, n = 3) for unilobar disease. We performed ultrasound, CT scan and MR I in each one. At MR imaging performed with T2 - weighted pulse secuences the lesion usually has high signal intensity. The Immunohistochemical study of the endothelial cells of the tumors (n=3) is positive for factor VIII related antigen. All are doing well except one patient died on respiratory failure post-operatively after a mean follow-up period of 2.7 years.

Conclusions: IHE of the liver is a very rare clinical entity. In our series study, if localized, hemangioendothelioma can be radical hepatic resected , with rapid control of symptoms.