Other Medical Treatments for Infantile Hemangioma and Congenital Vascular Tumors

Most of IHs do not need any therapy due to spontaneous regression, and medical treatment is currently only performed in complicated IHs by propranolol. In extremely rare situations, alternative medical therapies have to be administered, such as corticosteroids or vincristine. Interferon and other chemotherapeutics are no longer used. Other congenital vascular tumors that can easily be confounded with IH do not show spontaneous regression and have to be discriminated. In most cases, only clinical evolution or histology can help diagnose tufted angioma or subtypes of hemangioendothelioma. Surgery, laser therapy, embolization, and/or medical therapies are possible options. In addition, these other congenital vascular tumors often present with the Kasabach-Merritt phenomenon (KMP), including thrombocytopenia and activated consumptive coagulopathy. Guidelines for the medical therapy of KMP have been published, and corticosteroids in combination with vincristine were proposed as first-line therapy. Recently, the mTOR inhibitor rapamycin has been reported to show promising effects for congenital vascular tumors with or without KMP.