Efficacy and safety of propranolol in the treatment of parotid hemangioma

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.

[1]  A. Zaenglein Hypoglycemia in Children Taking Propranolol for the Treatment of Infantile Hemangioma , 2011 .

[2]  A. Erbay,et al.  Response of infantile hepatic hemangioma to propranolol resistant to high‐dose methylprednisolone and interferon‐α therapy , 2010, Pediatric blood & cancer.

[3]  P. Hoeger,et al.  Propranolol for infantile haemangiomas: insights into the molecular mechanisms of action , 2010, The British journal of dermatology.

[4]  Z. Qin,et al.  [Treatment of infantile parotid hemangioma with propranolol]. , 2010, Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology.

[5]  A. Mukherjee,et al.  Infantile hemangioendothelioma: A case report and discussion. , 2010, Pathology, research and practice.

[6]  D. Lipsker,et al.  Propranolol for Severe Infantile Hemangiomas: Follow-Up Report , 2009, Pediatrics.

[7]  W. Keenan,et al.  More on propranolol for hemangiomas of infancy. , 2008, The New England journal of medicine.

[8]  D. Adams,et al.  Infantile hemangiomas with unusually prolonged growth phase: a case series. , 2008, Archives of dermatology.

[9]  F. Boralevi,et al.  Propranolol for severe hemangiomas of infancy. , 2008, The New England journal of medicine.

[10]  V. Sharma,et al.  Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas. , 2004, Archives of dermatology.

[11]  J. Mulliken,et al.  Management of Parotid Hemangioma in 100 Children , 2004, Plastic and reconstructive surgery.

[12]  Chao‐Ping Yang,et al.  Hepatic hemangioendothelioma in children: analysis of thirteen cases. , 2003, Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi.