infantile hemangioma

婴儿血管瘤
  • 文章类型: Journal Article
    浅表性婴儿血管瘤(SIH)是最常见的IH类型。一些研究表明,755nm长脉冲翠绿宝石激光(LPAL)和局部2%盐酸卡替洛尔(C-HCL)滴眼液用于治疗SIH的功效。本文回顾性分析755nmLPAL联合2%C-HCL滴眼液治疗重度SIH的安全性和有效性。并探讨了SIH的最佳治疗时间。
    这项研究包括2-5毫米厚的SIH患者,他们接受了755-nmLPAL和2%C-HCL滴眼液的共同治疗。根据年龄和IH生长曲线将SIH患者分为3组:≤1个月(≤1M),1-3个月(不包括1个月;1-3M),和3-12个月(不包括3个月;3-12M)。
    ≤1M组和1-3M组的疗效没有差异,均优于3-12M组。此外,≤1M组和1-3M组的平均治疗次数没有差异,均少于3-12M组。两组不良反应发生率差异无统计学意义。与≤1M和1-3M组相比,3-12M组治疗后出现更多永久性皮肤损伤。
    据揭示,用755-nmLPAL和2%C-HCL滴眼液共同治疗对较厚的SIH是安全有效的。与3-12M组相比,≤3个月可取得较好疗效,需要更短的治疗时间,不太可能留下永久性皮肤损伤,如疤痕。此外,无增殖的患者可观察到1个月。
    UNASSIGNED: Superficial Infantile hemangioma (SIH) is the most common type of IH. Some studies have shown the efficacy of 755-nm long pulse alexandrite laser (LPAL) and topical 2% carteolol hydrochloride (C-HCL) eye drops for the treatment of SIH. This article retrospectively analyzes the safety and efficacy of 755-nm LPAL combined with 2% C-HCL eye drops for treating thicker SIH, and explores the optimal treatment time for SIH.
    UNASSIGNED: This study included 2-5 mm thick SIH patients who received co-treatment of 755-nm LPAL and 2% C-HCL eye drops. The SIH patients were divided into 3 groups based on their age and IH growth curve: ≤ 1 month (≤ 1M), 1-3 months (excluding 1 month; 1-3M), and 3-12 months (excluding 3 months; 3-12M).
    UNASSIGNED: There was no difference in efficacy between the ≤ 1M and the 1-3M group, and were both better than the 3-12M group. Furthermore, there was no difference in the average number of treatments between the ≤ 1M and 1-3M groups and were both less than the 3-12M group. There was no significant difference in the incidence of adverse reactions between the groups. Compared with the ≤ 1M and 1-3M groups, the 3-12M group indicated more permanent skin lesions after the treatment.
    UNASSIGNED: It was revealed that co-treatment with 755-nm LPAL and 2% C-HCL eye drops is safe and effective against thicker SIH. Compared with the 3-12M group, ≤ 3 months can achieve better efficacy, requires a shorter treatment time, less likely to leave permanent skin lesions such as scars. Moreover, patients with no proliferation can be observed to 1 month.
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  • 文章类型: Journal Article
    背景:腹膜后婴儿血管瘤(RIH),一种原发性腹膜后肿瘤,在临床实践中非常罕见。婴儿血管瘤通常表现在皮肤表面。RIH非常罕见,通常很小。在成年人中,这些肿瘤通常表现为没有特定的临床症状或明确诊断的可检测体征。该病例报告详述了一名诊断为RIH的患者。我们建议在全面评估后完全切除肿瘤,其次是术后病理,得到一个决定性的诊断.我们认为,术中管理关键的腹膜后结构和血管对涉及原发性腹膜后肿瘤的所有手术都提出了重大挑战。一名47岁的男性被诊断出患有胆结石,3个月前因无法解释的恶心和呕吐在其他机构接受了手术。手术后2个月的随访影像学显示,左侧肾极下方有腹膜后肿块。在向我们医院介绍时,患者持续出现间歇性恶心和呕吐,没有其他明显的症状或体征。考虑到患者8年的高血压病史,最初怀疑是副神经节瘤。经过详细评估后,我们进行了腹腔镜肿块切除术。然而,术后病理显示为毛细血管血管瘤(旧术语)/婴儿血管瘤。
    结论:RIHs是极其罕见的良性肿瘤。应该排除恶性肿瘤的可能性,在经过全面评估后,建议进行手术切除,经病理检查确诊。
    BACKGROUND: Retroperitoneal infantile hemangioma (RIH), a type of primary retroperitoneal tumors, are exceptionally rare in clinical practice. Infantile hemangiomas typically manifest on the skin\'s surface. RIHs are exceptionally rare and typically small. In adults, these tumors often manifest without specific clinical symptoms or detectable signs for a definitive diagnosis. This case report details a patient diagnosed with RIH. We recommend complete excision of the tumor after a comprehensive evaluation, followed by postoperative pathology, to achieve a conclusive diagnosis. We believe that managing critical retroperitoneal structures and vessels intraoperatively presents a significant challenge for all procedures involving primary retroperitoneal tumors. A 47-year-old male was diagnosed with gallstones and underwent surgery 3 months ago at other institution for unexplained nausea and vomiting. Follow-up imaging 2 months after surgery revealed a retroperitoneal mass below the left renal pole. Upon presentation to our hospital, the patient continued to experience intermittent nausea and vomiting, with no other significant symptoms or signs. Considering the patient\'s 8-year history of hypertension, a paraganglioma was initially suspected. We performed the laparoscopic mass resection after a detailed assessment. However, postoperative pathology revealed it a capillary hemangioma (old term)/infantile hemangioma.
    CONCLUSIONS: RIHs are exceedingly rare benign tumor. The possibility of malignancy should be ruled out, and surgical resection is recommended following a thorough evaluation, with the diagnosis confirmed through pathological examination.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    两种最常见的儿童血管异常是婴儿血管瘤(IH)和葡萄酒色斑(PWS)。它们在出生后不久变得明显,但具有不同的病理生理学和临床表现。这项研究的目的是确定母亲的血管瘤或PWS病史是否与这些血管异常有关。我们评估了英国匿名电子病历数据库,其中包含儿童与其母亲之间的关联病历。Cox比例风险模型用于评估母亲因素与儿童IH或PWS发作时间之间的关联。在2004年至2021年之间,有639,085名儿童与母亲的医疗数据相关联,共进行了4,270,773人年的随访。与没有血管瘤的母亲相比,患有血管瘤的母亲所生的孩子患IH的可能性高60%以上(HR:1.64[1.07,2.52])。患有PWS的母亲所生的孩子与没有PWS的母亲所生的孩子相比,患有PWS的可能性高出近20倍(18.95[4.71,76.26])。患有血管瘤的母亲不太可能有PWS的孩子,而患有PWS的母亲也不太可能有IH的孩子。调整后,效果估计值变化最小。我们证明,患有血管瘤或PWS的母亲所生的孩子患IH或PWS的风险增加,分别。
    The two most prevalent childhood vascular abnormalities are infantile hemangioma (IH) and port-wine stain (PWS). They become apparent shortly after birth but have distinct pathophysiology and clinical manifestations. The goal of this study was to determine if mother\'s history of angioma or PWS is associated with these vascular abnormalities. We evaluated an UK anonymized electronic medical records database with medical records that were linked between children and their mothers. Cox proportional hazards models were used to evaluate the association between maternal factors and the time of onset of either IH or PWS in children. Between 2004 and 2021, 639,085 children were linked to their mom\'s medical data with a total of 4,270,773 person-years of follow up. Children born to mothers with an angioma as compared to a mother without an angioma were more than 60% more likely to have an IH (HR: 1.64 [1.07, 2.52]). Children born to mothers with a PWS as compared to children born to mothers without a PWS were nearly 20 times more likely to have a PWS (18.95 [4.71,76.26]). Mothers with angiomas were not more likely to have children with PWS and mothers with PWS were not more likely to have children with IH. The effect estimates were minimally changed after adjustment. We demonstrated that children born to mothers with angiomas or PWS were at increased risk of IH or PWS, respectively.
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  • 文章类型: Journal Article
    越来越多的报道表明环状RNA(circularRNAs,circRNAs)和免疫细胞浸润与肿瘤的发展有关。然而,其在婴儿血管瘤(IH)中的作用尚不清楚。我们将探索一种新的基于hsa_circ_0006903的ceRNA网络,并研究树突状细胞在IH中激活表达的景观。
    差异表达的circRNAs(DEC)从基因表达综合(GEO)数据库中鉴定。构建了调控网络和功能富集分析。CIBERSORT用于表征免疫细胞组成。进行qRT-PCR以检测细胞系中hsa_circ_0006903的表达。然后,使用transwell测定法在体外验证了hsa_circ_0006903在IH中的作用。将免疫荧光应用于在IH组织中作为生物标志物活化的树突状细胞的CD11b的共定位。
    使用GEO数据库,在IH中总共筛选出67个DEC。Hsa_circ_0006903是最显著的DEC。然后,构建了一个新的hsa_circ_0006903环状RNA-ceRNA网络。机械上,功能富集分析表明,p53信号通路发挥了最重要的作用,和hsa_circ_0006903/miR-6721-5p/CACNA2D2和hsa_circ_0006903/miR-4786-3p/ATP13A4轴被鉴定。CACNA2D2、ATP13A4和P53在IH细胞系中显著下调。我们验证了激活的树突状细胞显著过表达。此外,在IH组织中测试CD11b作为活化的树突状细胞的生物标志物。最后,hsa_circ_0006903显著过表达,和hsa_circ_0006903促进婴儿血管瘤细胞增殖,入侵,和体外迁移。
    总的来说,我们的研究表明,一种新的hsa_circ_0006903促进肿瘤进展,并表明在IH中激活的树突状细胞的潜在生物标志物CD11b。
    UNASSIGNED: Increasing reports revealed that circular RNAs (circRNAs) and immune cells infiltration were related with tumor development. However, its role in infantile hemangioma (IH) is unknown. We will explore a novel hsa_circ_0006903-based ceRNA network and investigate the landscape of dendritic cells activated expression in IH.
    UNASSIGNED: Differentially expressed circRNAs (DECs) were identified from Gene Expression Omnibus (GEO) database. Regulatory networks and functional enrichment analysis were constructed. CIBERSORT was used to characterize immune cells composition. qRT-PCR was performed to detect the expression of hsa_circ_0006903 in cell lines. Then, the role of hsa_circ_0006903 in IH were validated in vitro using transwell assay. Immunofluorescence was applied to the colocalization of CD11b for dendritic cells activated as a biomarker in IH tissues.
    UNASSIGNED: Using GEO database, a total of 67 DECs were screened out in IH. Hsa_circ_0006903 was the most significant DECs. Then, a novel hsa_circ_0006903 circular RNA-ceRNA network was constructed. Mechanistically, functional enrichment analysis showed that the p53 signaling pathway played the most important roles, and hsa_circ_0006903/miR-6721-5p/CACNA2D2 and hsa_circ_0006903/miR-4786-3p/ATP13A4 axis were identified. CACNA2D2, ATP13A4, and P53 were significantly downregulated in IH cell lines. We validated that dendritic cell activated was significantly overexpressed. Moreover, CD11b as a biomarker of dendritic cells activated were tested in IH tissues. Finally, hsa_circ_0006903 was significantly overexpressed, and hsa_circ_0006903 promoted infantile hemangioma cell proliferation, invasion, and migration in vitro.
    UNASSIGNED: Overall, our study revealed that a novel hsa_circ_0006903 promoted tumor progression, and indicated a potential biomarker CD11b of dendritic cells activated in IH.
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  • 文章类型: Case Reports
    婴儿血管瘤(IHs)是影响婴儿的常见良性血管肿瘤。在这个案例报告中,我们详细介绍了在没有医疗干预的情况下监测四个月以上的婴儿的IH的自然过程,说明此类病变的良性进展和自发稳定的潜力。目的是观察血管瘤的大小和形态的变化,除了婴儿的整体健康和发育里程碑,通过定期的临床评估。这个案例提出了一个挑战,病人的父母缺乏英语流利,缺乏医疗服务,社会经济地位较低。它强调了个性化患者护理的重要性,提倡在临床上不必要时仔细观察和限制药物治疗的应用。该报告通过强调IH的自然良性行为以及对治疗决策的平衡方法的需要,为现有的儿科皮肤病学知识做出了贡献。确保患者安全和有利的长期结果。
    Infantile hemangiomas (IHs) are common benign vascular tumors that affect infants. In this case report, we detail the natural course of an IH in an infant monitored over four months without medical intervention, illustrating the benign progression and potential for spontaneous stabilization of such lesions. The aim was to observe changes in the size and morphology of the hemangioma, alongside the infant\'s overall health and developmental milestones, through regular clinical assessments. This case presented a challenge as the patient\'s parents lacked English fluency, lacked healthcare access, and had low socioeconomic status. It highlights the importance of individualized patient care, advocating for careful observation and restraint in the application of pharmacological treatments when clinically unnecessary. The report contributes to existing pediatric dermatology knowledge by emphasizing the natural benign behavior of IH and the need for a balanced approach to treatment decisions, ensuring safe and favorable long-term outcomes for patients.
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  • 文章类型: Journal Article
    婴儿血管瘤(IH)是婴儿最常见的良性肿瘤,通常可以自行解决。然而,一小部分IH病例伴有严重并发症和其他问题,影响受影响儿童的身心健康。IH的发病机制存在很大争议。研究表明血管形成异常是IH发生发展的重要病理基础。与正常组织相比,肿瘤部位血管生长的平衡被破坏,以及其他类型细胞之间的相互作用,比如免疫细胞,促进血管组织细胞的快速增殖和迁移以及血管网络的构建。目前,普萘洛尔是用于抑制IHs生长并加速其消退的最常见的全身性药物。本文旨在为IH中血管生成机制的研究提供最新综述。我们讨论了三个主要因素的可能作用,即,雌激素,缺氧,和炎症,在IH的发展中。此外,我们总结了肿瘤细胞亚群的关键作用,例如周细胞,考虑到过去几年的证据,在IH的扩散和消退中,强调普萘洛尔治疗IH的可能机制。血管生成是IH发生发展过程中的重要事件,深入了解血管生成的分子机制将为IH的生物学和临床治疗提供新的见解。
    Infantile hemangioma (IH) is the most common benign tumor in infants and usually resolves on its own. However, a small portion of IH cases are accompanied by serious complications and other problems, impacting the physical and psychological health of the children affected. The pathogenesis of IH is highly controversial. Studies have shown that abnormal blood vessel formation is an important pathological basis for the development of IH. Compared with that in normal tissues, the equilibrium of blood vessel growth at the tumor site is disrupted, and interactions among other types of cells, such as immune cells, promote the rapid proliferation and migration of vascular tissue cells and the construction of vascular networks. Currently, propranolol is the most common systemic drug used to inhibit the growth of IHs and accelerate their regression. The purpose of this review is to provide the latest research on the mechanisms of angiogenesis in IH. We discuss the possible roles of three major factors, namely, estrogen, hypoxia, and inflammation, in the development of IH. Additionally, we summarize the key roles of tumor cell subpopulations, such as pericytes, in the proliferation and regression of IH considering evidence from the past few years, with an emphasis on the possible mechanisms of propranolol in the treatment of IH. Angiogenesis is an important event during the development of IH, and an in-depth understanding of the molecular mechanisms of angiogenesis will provide new insights into the biology and clinical treatment of IH.
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  • 文章类型: Journal Article
    婴儿血管瘤(IH),儿科最常见的血管肿瘤,被认为是由干细胞对刺激如缺氧的异常反应引起的。这篇综述探讨了不同的表现形式,并发症,以及IH的管理策略,强调多学科方法的重要性。与IH相关的流行病学和危险因素,包括与早产的联系,低出生体重,家庭背景,正在讨论。涉及血管瘤干细胞的复杂发病机制,KIAA1429,缺氧,并检查肾素-血管紧张素系统。自然史和临床特征,以及皮外受累,如肝IH,PHACES综合征,和腰椎综合征,是详细的。溃疡等并发症,功能损害,甲状腺功能减退,强调了化妆品的担忧。鉴别诊断和诊断模式,包括色度计,高频超声检查,和成像技术,正在讨论。管理方法,包括使用普萘洛尔,阿替洛尔,皮质类固醇,替代系统治疗,局部治疗,激光治疗,和手术,全面审查。强调了IH管理不断发展的格局,正在进行的研究探索替代治疗和基于IH特征的个性化方法。
    Infantile hemangioma (IH), the most common vascular tumor in pediatrics, is thought to arise from aberrant stem cell responses to stimuli such as hypoxia. This review explores the diverse manifestations, complications, and management strategies for IH, emphasizing the importance of a multidisciplinary approach. The epidemiology and risk factors associated with IH, including connections to prematurity, low birth weight, and family background, are discussed. The intricate pathogenesis involving hemangioma stem cells, KIAA1429, hypoxia, and the renin-angiotensin system is examined. The natural history and clinical features, as well as extracutaneous involvements such as hepatic IH, PHACES syndrome, and LUMBAR syndrome, are detailed. Complications such as ulceration, functional impairment, hypothyroidism, and cosmetic concerns are highlighted. The differential diagnosis and diagnostic modalities, including colorimeters, high-frequency ultrasonography, and imaging techniques, are discussed. Management approaches, including the use of propranolol, atenolol, corticosteroids, alternative systemic treatments, topical therapy, laser therapy, and surgery, are comprehensively reviewed. The evolving landscape of IH management is underscored, with ongoing research exploring alternative treatments and individualized approaches based on IH characteristics.
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  • 文章类型: Journal Article
    作为婴儿最常见的良性血管瘤,婴儿血管瘤(IH)的特征是在婴儿期早期快速生长和血管生成,然后随着时间的推移自发退化成纤维脂肪组织。大量证据表明,IH起源于血管瘤干细胞(HemSCs),一组具有克隆扩增和多向分化能力的干细胞。然而,在IH发育过程中,控制HemSCs细胞命运转变的复杂机制仍然难以捉摸。在这里,我们全面检查IH的细胞组成,强调各种IH细胞类型的细微差别特性及其与肿瘤临床特征的相关性。我们还总结了目前对指导HemSC分化为内皮细胞(ECs)的调节途径的理解,周细胞,和脂肪细胞在整个IH进展和退化阶段。此外,我们讨论了在生理条件下解开EC和脂肪细胞发育的转录和表观遗传调控的最新进展,这为理解IH发病机制提供了至关重要的观点。
    As the most common benign vascular tumor in infants, infantile hemangioma (IH) is characterized by rapid growth and vasculogenesis early in infancy, followed by spontaneous involution into fibrofatty tissues over time. Extensive evidence suggests that IH originates from hemangioma stem cells (HemSCs), a group of stem cells with clonal expansion and multi-directional differentiation capacity. However, the intricate mechanisms governing the cell fate transition of HemSCs during IH development remain elusive. Here we comprehensively examine the cellular composition of IH, emphasizing the nuanced properties of various IH cell types and their correlation with the clinical features of the tumor. We also summarize the current understanding of the regulatory pathways directing HemSC differentiation into endothelial cells (ECs), pericytes, and adipocytes throughout the stages of IH progression and involution. Furthermore, we discuss recent advances in unraveling the transcriptional and epigenetic regulation of EC and adipocyte development under physiological conditions, which offer crucial perspectives for understanding IH pathogenesis.
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  • 文章类型: Journal Article
    Infantile hemangioma is a benign vascular tumor, the most common in childhood, whose natural evolution is the disappearance of the lesion in the pediatric age and which has effective and safe treatments that limit its growth and favor its disappearance at younger ages. Infantile hemangioma continues to be a reason for attention to complications, due to erroneous diagnoses, lack of knowledge of the condition, late referral or fear of the effects of the medications used for its treatment. Furthermore, its presence is normalized without taking into account that it can cause uncertainty, anxiety, feelings of guilt and, as a consequence, a significant impact on the quality of life, mainly in the parents or caregivers of the child. The need for a clinical practice guideline in our country arises from the high presentation of late-remitted complications in infantile hemangioma even with the availability of adequate treatments, the continuous evolution of medicine and the appearance of new evidence. Throughout the guide you will find recommendations regarding the diagnosis, treatment and follow-up of patients with infantile hemangioma, taking into account the paraclinical tests that can be performed, topical or systemic management options, as well as adjuvant therapies. For the first time, objective tools for patient follow-up are included in a guide for the management of infantile hemangioma, as well as to help the first contact doctor in timely referral.
    El hemangioma infantil es un tumor vascular benigno, el más frecuente de la infancia, cuya evolución natural favorece la desaparición de la lesión en la misma edad pediátrica y que cuenta con tratamientos eficaces y seguros que limitan su crecimiento y favorecen su desaparición a edades más tempranas. Continúa siendo motivo de atención de complicaciones, debido a diagnósticos erróneos, desconocimiento del padecimiento, referencia tardía o temor de los efectos de los fármacos utilizados para su tratamiento. Además, se normaliza su presencia sin tomar en cuenta que puede llegar a causar incertidumbre, ansiedad, sentimientos de culpa y, como consecuencia, importante afectación de la calidad de vida, principalmente en los padres o cuidadores del niño. La necesidad de una guía de práctica clínica en nuestro país surge ante la alta presentación de complicaciones del hemangioma infantil referidas de manera tardía aun con la disponibilidad de tratamientos adecuados, la evolución continua de la medicina y la aparición de nueva evidencia. A lo largo de la guía se encontrarán recomendaciones en relación con el diagnóstico, el tratamiento y el seguimiento de los pacientes con hemangioma infantil, tomando en cuenta los paraclínicos que pueden realizarse, las opciones de manejo tópico o sistémico, y las terapias adyuvantes. Por primera vez se incluyen en una guía para el manejo del hemangioma infantil herramientas objetivas para el seguimiento de los pacientes, así como para ayudar al médico de primer contacto en su referencia oportuna.
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