A case series of tardive expansion congenital hemangioma: A variation of noninvoluting congenital hemangioma or a new hemangiomatous entity?

BACKGROUND

Congenital hemangiomas present fully grown at birth and share a remarkably similar lack of disproportionate or accelerated postnatal proliferation.

OBJECTIVE

We report a series of unusual congenital hemangiomas that arise prenatally and initially exhibit a proportional growth pattern similar to that of noninvoluting congenital hemangioma. However, a tardive expansion of the lesion, similar to the proliferation phase of infantile hemangioma, occurs later during childhood.

METHODS

A total of 11 unusual congenital hemangiomas were reviewed in regard to clinical presentation, imaging, and pathologic characteristics.

RESULTS

The infants included 9 boys and 2 girls. The tumors were located in the head and neck (n=10) and abdominal wall (n=1). Spontaneous expansion began at the age of 12 months to 61 months, as determined from clinic notes and paired follow-up photographs. Uniform parenchymal masses and fast-flow vessels were confirmed by imaging examination. There are both histopathological overlap and distinction between these lesions and other congenital hemangiomas.

LIMITATIONS

Only a small number of cases were identified.

CONCLUSION

We propose that these lesions be denominated "tardive expansion congenital hemangioma (TECH)" to indicate their specific clinical and histological distinctiveness. Recognition of these distinct lesions will contribute to a better understanding of congenital hemangiomas.