Successful treatment of a large hemangioma with propranolol

Summary Hemangiomas are the most common vascular tumors in children. They occur in 8–12% of all infants and in 22% of premature infants (female: male = 3: 1). Hemangiomas are usually sporadic; their etiology is unknown [1]. A premature female infant, born at 28 weeks of gestation, presented with a large hemangioma of the right thoracic wall. Within the first few weeks, the hemangioma showed rapid horizontal and vertical growth as well as ulceration, which led us to initiate systemic therapy. The effectiveness of propranolol (non-selective s-blocker) in the management of severe cases of hemangioma has been shown in a recent series of cases [2]. We began oral propranolol treatment, in close interdisciplinary cooperation. After a few days of therapy, the tumor had stopped expanding. After 18 weeks, there has been marked regression but the therapy is still being continued. We propose that propranolol may be an effective and relatively well tolerable alternative in the management of selected cases of severe hemangiomas in infancy, providing interdisciplinary cooperation between dermatologists and pediatricians is available.