Management of infantile parotid gland hemangiomas: a 40-year experience.

Background: Infantile hemangiomas represent one of the most common childhood tumors. The authors have previously demonstrated that the most appropriate management for such tumors is a nonoperative approach. Some authors have recently advocated surgical management as the primary treatment. Medical treatment such as steroids or interferon therapy has also been proposed. Definitive treatment for infantile parotid gland hemangioma remains controversial. Methods: In the retrospective study portion of this article, the authors reviewed the last 400 charts of children with hemangiomas managed at the Montreal Children's Hospital over the past 40 years. Twenty patients with parotid hemangiomas were identified. In the literature review portion, the Ovid MEDLINE and PubMed databases were used to retrieve all published original articles on the management of parotid hemangiomas from 1950 to December of 2008. Results: All of the authors' patients underwent successful nonoperative management, with 100 percent resolution of their parotid hemangiomas within 2 years of diagnosis, with an average follow-up time of 8.6 ± 5.7 years. There were no complications of any of the treatments. The literature review retrieved a total of 413 patients in 12 original articles and four case reports. Management included observation and medical (steroid or interferon) and/or surgical treatment. Complications included failure to thrive, scarring, facial nerve palsy, and death. Conclusions: The authors have shown that nonoperative therapy resulted in regression and involution of infantile parotid hemangiomas with no major complications.