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Published in: Clinical Sarcoma Research 1/2020

01-12-2020 | Propranolol | Case Report

A case report of Kaposiform haemangioendothelioma; response with propranolol and steroids

Authors: Saurav Verma, Ekta Dhamija, Adarsh Barwad, Venkatesan S. Kumar, Sameer Rastogi

Published in: Clinical Sarcoma Research | Issue 1/2020

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Abstract

Background

Kaposiform haemangioendothelioma is a rare vascular tumor and may involve skin, deep soft tissue or bone. It is a locally aggressive tumor usually seen in infants. Here we report a case of kaposiform hemagioendothelioma in a child who responded to propranolol and steroids.

Case presentation

A 3-year-old male child presented with a swelling below his right knee with characteristic violet skin lesion. There was no evidence of Kasabach–Merritt phenomenon. After no improvement with several attempts at debridement and anti-tubercular treatment; a diagnosis of Kaposiform Haemangioendothelioma was reached on the basis of overall clinical picture and histology. The child was treated with propranolol and steroids and had an excellent clinical response and a near complete resolution on imaging at 5 months.

Conclusions

These cases are often misdiagnosed and despite a delay in diagnosis have good outcomes with appropriate multimodality management. This case highlights the unique and typical characteristics of kaposiform haemangioendothelioma.
Literature
1.
go back to reference Zukerberg LR, Nickoloff BJ, Weiss SW. Kaposiform hemangioendothelioma of infancy and childhood. An aggressive neoplasm associated with Kasabach–Merritt syndrome and lymphangiomatosis. Am J Surg Pathol. 1993;17(4):321–8.PubMedCrossRef Zukerberg LR, Nickoloff BJ, Weiss SW. Kaposiform hemangioendothelioma of infancy and childhood. An aggressive neoplasm associated with Kasabach–Merritt syndrome and lymphangiomatosis. Am J Surg Pathol. 1993;17(4):321–8.PubMedCrossRef
2.
go back to reference Ji Y, Chen S, Peng S, Xia C, Li L. Kaposiform lymphangiomatosis and kaposiform hemangioendothelioma: similarities and differences. Orphanet J Rare Dis. 2019;14:165.PubMedPubMedCentralCrossRef Ji Y, Chen S, Peng S, Xia C, Li L. Kaposiform lymphangiomatosis and kaposiform hemangioendothelioma: similarities and differences. Orphanet J Rare Dis. 2019;14:165.PubMedPubMedCentralCrossRef
3.
go back to reference Croteau SE, Liang MG, Kozakewich HP, Alomari AI, Fishman SJ, Mulliken JB, et al. Kaposiform hemangioendothelioma: atypical features and risks of Kasabach–Merritt phenomenon in 107 referrals. J Pediatr. 2013;162(1):142–7.PubMedCrossRef Croteau SE, Liang MG, Kozakewich HP, Alomari AI, Fishman SJ, Mulliken JB, et al. Kaposiform hemangioendothelioma: atypical features and risks of Kasabach–Merritt phenomenon in 107 referrals. J Pediatr. 2013;162(1):142–7.PubMedCrossRef
4.
go back to reference Fernández Y, Bernabeu-Wittel M, García-Morillo JS. Kaposiform hemangioendothelioma. Eur J Intern Med. 2009;20(2):106–13.PubMedCrossRef Fernández Y, Bernabeu-Wittel M, García-Morillo JS. Kaposiform hemangioendothelioma. Eur J Intern Med. 2009;20(2):106–13.PubMedCrossRef
5.
go back to reference Enomoto Y, Yoshimura S, Egashira Y, Iwama T. Transarterial embolization for cervical hemangioma associated with Kasabach–Merritt syndrome. Neurol Med Chir (Tokyo). 2011;51(5):375–8.CrossRef Enomoto Y, Yoshimura S, Egashira Y, Iwama T. Transarterial embolization for cervical hemangioma associated with Kasabach–Merritt syndrome. Neurol Med Chir (Tokyo). 2011;51(5):375–8.CrossRef
6.
go back to reference Haisley-Royster C, Enjolras O, Frieden I, Garzon M, Lee M, de Laat P, et al. Kasabach–Merritt phenomenon: a retrospective study of treatment with Vincristine. J Pediatr Hematol Oncol. 2002;24(6):459–62.PubMedCrossRef Haisley-Royster C, Enjolras O, Frieden I, Garzon M, Lee M, de Laat P, et al. Kasabach–Merritt phenomenon: a retrospective study of treatment with Vincristine. J Pediatr Hematol Oncol. 2002;24(6):459–62.PubMedCrossRef
7.
go back to reference Banavali S, Pasquier E, André N. Targeted therapy with propranolol and metronomic chemotherapy combination: sustained complete response of a relapsing metastatic angiosarcoma. 2015. https://journal/9/full/499-targeted-therapy-with-propranolol-and-metronomic-chemotherapy-combination-sustained-complete-response-of-a-relapsing-metastatic-angiosarcoma.php Banavali S, Pasquier E, André N. Targeted therapy with propranolol and metronomic chemotherapy combination: sustained complete response of a relapsing metastatic angiosarcoma. 2015. https://​journal/​9/​full/​499-targeted-therapy-with-propranolol-and-metronomic-chemotherapy-combination-sustained-complete-response-of-a-relapsing-metastatic-angiosarcoma.​php
8.
go back to reference Hermans DJ, Beynum I van, Vijver R van der, Kool LJS, Blaauw I de, Vleuten CJ van der. Kaposiform hemangioendothelioma with Kasabach–Merritt syndrome: a new indication for propranolol treatment. J Pediatr Hematol Oncol. 2011;33(4). insights.ovid.com Hermans DJ, Beynum I van, Vijver R van der, Kool LJS, Blaauw I de, Vleuten CJ van der. Kaposiform hemangioendothelioma with Kasabach–Merritt syndrome: a new indication for propranolol treatment. J Pediatr Hematol Oncol. 2011;33(4). insights.ovid.com
9.
go back to reference Hammill AM, Wentzel M, Gupta A, Nelson S, Lucky A, Elluru R, et al. Sirolimus for the treatment of complicated vascular anomalies in children. Pediatr Blood Cancer. 2011;57(6):1018–24.PubMedCrossRef Hammill AM, Wentzel M, Gupta A, Nelson S, Lucky A, Elluru R, et al. Sirolimus for the treatment of complicated vascular anomalies in children. Pediatr Blood Cancer. 2011;57(6):1018–24.PubMedCrossRef
10.
go back to reference Sarkar M, Mulliken J, Kozakewich H, Robertson R, Burrows P. Thrombocytopenic coagulopathy (Kasabach–Merritt phenomenon) is associated with Kaposiform hemangioendothelioma and not with common infantile hemangioma. Plast Reconstr Surg. 1997;100(6):1377–86.PubMedCrossRef Sarkar M, Mulliken J, Kozakewich H, Robertson R, Burrows P. Thrombocytopenic coagulopathy (Kasabach–Merritt phenomenon) is associated with Kaposiform hemangioendothelioma and not with common infantile hemangioma. Plast Reconstr Surg. 1997;100(6):1377–86.PubMedCrossRef
11.
go back to reference Gruman A, Liang MG, Mulliken JB, Fishman SJ, Burrows PE, Kozakewich HPW, et al. Kaposiform hemangioendothelioma without Kasabach–Merritt phenomenon. J Am Acad Dermatol. 2005;52(4):616–22.PubMedCrossRef Gruman A, Liang MG, Mulliken JB, Fishman SJ, Burrows PE, Kozakewich HPW, et al. Kaposiform hemangioendothelioma without Kasabach–Merritt phenomenon. J Am Acad Dermatol. 2005;52(4):616–22.PubMedCrossRef
12.
go back to reference Carrington PR. Truncal location of hemangioendotheliomas may indicate potentially more serious involvement with resulting Kasabach–Merritt syndrome than size determinant alone. J Am Acad Dermatol. 2006;54(5):922–3.PubMedCrossRef Carrington PR. Truncal location of hemangioendotheliomas may indicate potentially more serious involvement with resulting Kasabach–Merritt syndrome than size determinant alone. J Am Acad Dermatol. 2006;54(5):922–3.PubMedCrossRef
13.
go back to reference Wolfe SQ, Farhat H, Elhammady MS, Moftakhar R, Aziz-Sultan MA. Transarterial embolization of a scalp hemangioma presenting with Kasabach–Merritt syndrome: case report. J Neurosurg Pediatr. 2009;4(5):453–7.PubMedCrossRef Wolfe SQ, Farhat H, Elhammady MS, Moftakhar R, Aziz-Sultan MA. Transarterial embolization of a scalp hemangioma presenting with Kasabach–Merritt syndrome: case report. J Neurosurg Pediatr. 2009;4(5):453–7.PubMedCrossRef
14.
go back to reference Pasquier E, André N, Street J, Chougule A, Rekhi B, Ghosh J, et al. Effective management of advanced angiosarcoma by the synergistic combination of propranolol and vinblastine-based metronomic chemotherapy: a bench to bedside study. EBioMedicine. 2016;17(6):87–95.CrossRef Pasquier E, André N, Street J, Chougule A, Rekhi B, Ghosh J, et al. Effective management of advanced angiosarcoma by the synergistic combination of propranolol and vinblastine-based metronomic chemotherapy: a bench to bedside study. EBioMedicine. 2016;17(6):87–95.CrossRef
15.
go back to reference Chiu YE, Drolet BA, Blei F, Carcao M, Fangusaro J, Kelly ME, et al. Variable response to propranolol treatment of Kaposiform hemangioendothelioma, tufted angioma, and Kasabach–Merritt phenomenon. Pediatr Blood Cancer. 2012;59(5):934–8.PubMedPubMedCentralCrossRef Chiu YE, Drolet BA, Blei F, Carcao M, Fangusaro J, Kelly ME, et al. Variable response to propranolol treatment of Kaposiform hemangioendothelioma, tufted angioma, and Kasabach–Merritt phenomenon. Pediatr Blood Cancer. 2012;59(5):934–8.PubMedPubMedCentralCrossRef
16.
go back to reference Liu XH, Li JY, Qu XH, Yan WL, Zhang L, Yang C, et al. Treatment of Kaposiform hemangioendothelioma and tufted angioma. Int J Cancer. 2016;139(7):1658–66.PubMedCrossRef Liu XH, Li JY, Qu XH, Yan WL, Zhang L, Yang C, et al. Treatment of Kaposiform hemangioendothelioma and tufted angioma. Int J Cancer. 2016;139(7):1658–66.PubMedCrossRef
17.
go back to reference Fernandez-Pineda I, Lopez-Gutierrez JC, Ramirez G, Marquez C. Vincristine-ticlopidine-aspirin: an effective therapy in children with Kasabach–Merritt phenomenon associated with vascular tumors. Pediatr Hematol Oncol. 2010;27(8):641–5.PubMedCrossRef Fernandez-Pineda I, Lopez-Gutierrez JC, Ramirez G, Marquez C. Vincristine-ticlopidine-aspirin: an effective therapy in children with Kasabach–Merritt phenomenon associated with vascular tumors. Pediatr Hematol Oncol. 2010;27(8):641–5.PubMedCrossRef
18.
go back to reference Fernandez-Pineda I, Lopez-Gutierrez JC, Chocarro G, Bernabeu-Wittel J, Ramirez-Villar GL. Long-term outcome of vincristine-aspirin-ticlopidine (VAT) therapy for vascular tumors associated with Kasabach–Merritt phenomenon. Pediatr Blood Cancer. 2013;60(9):1478–81.PubMedCrossRef Fernandez-Pineda I, Lopez-Gutierrez JC, Chocarro G, Bernabeu-Wittel J, Ramirez-Villar GL. Long-term outcome of vincristine-aspirin-ticlopidine (VAT) therapy for vascular tumors associated with Kasabach–Merritt phenomenon. Pediatr Blood Cancer. 2013;60(9):1478–81.PubMedCrossRef
19.
go back to reference Hauer J, Graubner U, Konstantopoulos N, Schmidt S, Pfluger T, Schmid I. Effective treatment of Kaposiform hemangioendotheliomas associated with Kasabach–Merritt phenomenon using four-drug regimen. Pediatr Blood Cancer. 2007;49(6):852–4.PubMedCrossRef Hauer J, Graubner U, Konstantopoulos N, Schmidt S, Pfluger T, Schmid I. Effective treatment of Kaposiform hemangioendotheliomas associated with Kasabach–Merritt phenomenon using four-drug regimen. Pediatr Blood Cancer. 2007;49(6):852–4.PubMedCrossRef
20.
go back to reference Blatt J, Stavas J, Moats-Staats B, Woosley J, Morrell DS. Treatment of childhood Kaposiform hemangioendothelioma with sirolimus. Pediatr Blood Cancer. 2010;55(7):1396–8.PubMedCrossRef Blatt J, Stavas J, Moats-Staats B, Woosley J, Morrell DS. Treatment of childhood Kaposiform hemangioendothelioma with sirolimus. Pediatr Blood Cancer. 2010;55(7):1396–8.PubMedCrossRef
21.
go back to reference Phillips WG, Marsden JR. Kasabach–Merritt syndrome exacerbated by platelet transfusion. J R Soc Med. 1993;86(4):231–2.PubMedPubMedCentral Phillips WG, Marsden JR. Kasabach–Merritt syndrome exacerbated by platelet transfusion. J R Soc Med. 1993;86(4):231–2.PubMedPubMedCentral
22.
go back to reference Drolet BA, Trenor CC, Brandão LR, Chiu YE, Chun RH, Dasgupta R, et al. Consensus-derived practice standards plan for complicated Kaposiform hemangioendothelioma. J Pediatr. 2013;163(1):285–91.PubMedCrossRef Drolet BA, Trenor CC, Brandão LR, Chiu YE, Chun RH, Dasgupta R, et al. Consensus-derived practice standards plan for complicated Kaposiform hemangioendothelioma. J Pediatr. 2013;163(1):285–91.PubMedCrossRef
23.
go back to reference Wang Z, Li K, Yao W, Dong K, Xiao X, Zheng S. Steroid-resistant Kaposiform hemangioendothelioma: a retrospective study of 37 patients treated with vincristine and long-term follow-up. Pediatr Blood Cancer. 2015;62(4):577–80.PubMedCrossRef Wang Z, Li K, Yao W, Dong K, Xiao X, Zheng S. Steroid-resistant Kaposiform hemangioendothelioma: a retrospective study of 37 patients treated with vincristine and long-term follow-up. Pediatr Blood Cancer. 2015;62(4):577–80.PubMedCrossRef
24.
go back to reference Rastogi S, Aggarwal A, Soti KR, Vanidassane I, Sharma MC, Yadav A, et al. Discordance of histo-pathological diagnosis of patients with soft tissue sarcoma referred to tertiary care center. J Clin Oncol. 2017;35(15_suppl):11064–11064.CrossRef Rastogi S, Aggarwal A, Soti KR, Vanidassane I, Sharma MC, Yadav A, et al. Discordance of histo-pathological diagnosis of patients with soft tissue sarcoma referred to tertiary care center. J Clin Oncol. 2017;35(15_suppl):11064–11064.CrossRef
Metadata
Title
A case report of Kaposiform haemangioendothelioma; response with propranolol and steroids
Authors
Saurav Verma
Ekta Dhamija
Adarsh Barwad
Venkatesan S. Kumar
Sameer Rastogi
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Propranolol
Published in
Clinical Sarcoma Research / Issue 1/2020
Electronic ISSN: 2045-3329
DOI
https://doi.org/10.1186/s13569-020-00134-8

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