Effect of oral propranolol on periocular infantile capillary hemangioma: Outcomes based on extent of involvement

Abstract Background: Thyroid hemangioma mostly occurs in adults and is extremely rare in infants. So far, only four pediatric cases of thyroid hemangioma have been reported, one of which has only been clinically diagnosed. Most of the reported cases are of cavernous hemangiomas; capillary hemangioma cases are very rare. To date, there are no reports on capillary thyroid hemangioma in an infant. Therefore, here we present the case of an infant with a primary capillary hemangioma of the thyroid gland, and discuss its treatment and follow-up.Case Presentation: A 2-month-old infant with normal thyroid function presented with airway obstruction as the primary manifestation of thyroid hemangioma. The main symptoms were laryngeal wheezing and dyspnea. Ultrasonography revealed hypoechoic lesions at the lower pole of the bilateral thyroid. Computed tomography revealed enlargement of the thyroid gland, inhomogeneous parenchyma enhancement, and multiple thyroid nodules. However, these imaging modalities were unable to provide an exact diagnosis and the nature of the tumor remained unknown prior to an operation. Therefore, a postoperative histopathological examination was undertaken, which revealed capillary thyroid hemangioma. The symptoms significantly improved by a combined treatment involving surgery and oral propranolol (2 mg/kg per day).Conclusion: When a well-defined capsulate mass is detected on the medical image, the possibility of primary thyroid hemangioma must be considered.

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Oral Propranolol Therapy for Benign Capillary Hemangiomas in a Series of Adult and Pediatric Patients

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v32i2.75 ◽

2018 ◽

Vol 32 (2) ◽

pp. 34-37

Author(s):

Gerardo Aniano C. Dimaguila ◽

Emmanuel S. Samson

Keyword(s):

Head And Neck ◽

Pediatric Patients ◽

Case Series ◽

Lesion Size ◽

Capillary Hemangioma ◽

Clinical Resolution ◽

Prospective Case Series ◽

The Right ◽

Propranolol Therapy ◽

Oral Propranolol

Objective: To describe outcomes of oral propranolol therapy in a series of adult and pediatric patients diagnosed with benign capillary hemangioma of the head and neck. Methods: Design: Prospective Case Series Setting: Tertiary Government Hospital Participants: Ten (10) patients representing all patients clinically diagnosed with benign capillary hemangioma of the head and neck, enrolled in the study from 2012 to 2015. Results: Two (2) adults and eight (8) children were enrolled in the study. Although a decrease in lesion size was observed in half of the participants starting at three months, only one (1) attained complete resolution of the lesion-- a 12-year-old girl with hemangioma of the right parotid gland that attained clinical resolution of symptoms after four months of treatment. The remaining nine out of ten (9/10) participants did not attain complete clinical resolution; but there was a decrease in lesion size in four (4) of these participants. For the remaining five (5) participants, there was neither a decrease nor an increase in lesion size. Altogether, of the two adult participants, only one responded to therapy, while only 4 out of 8 pediatric participants responded to therapy. There were no noticeable differences between adult and pediatric patients in terms of resolution and plateau. Aside from mild bradycardia expected with propranolol, no adverse reactions were observed during the course of treatment. Conclusion: Although half of our participants responded to oral propranolol therapy, whether these observations may be attributable to oral propranolol alone cannot be concluded. Keywords: hemangioma, capillary; hemangioma; propranolol administration, oral; propranolol

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Periocular capillary hemangioma treated with low dose oral propranolol - presentation and outcome of 30 patients

Archives of Pathology and Clinical Research ◽

10.29328/journal.apcr.1001027 ◽

2021 ◽

Vol 5 (1) ◽

pp. 037-041

Author(s):

Roy Soma Rani ◽

Nuruddin Murtuza

Keyword(s):

Low Dose ◽

Color Change ◽

Initial Response ◽

Capillary Hemangioma ◽

Response To Treatment ◽

P Value ◽

Outpatient Basis ◽

Cost Effective Treatment ◽

Dose Oral ◽

Oral Propranolol

Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol. Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol. Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis.

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