Rapidly involuting congenital haemangioma – uncommon diagnosis

Abstract

Rapidly involuting congenital hemangiomas (RICH) are rare vascular tumors which are characterized for being fully developed at birth and involute completely and spontaneously within six to eighteen months. The diagnosis is mostly achieved by history and physical examination, sometimes aided by imaging studies and biopsy.
It is described the case of a term newborn, from a surveilled pregnancy with normal prenatal ultrasounds, who presented at birth a mass of 5x4.5cm on the anterior surface of the left thigh that was soft, compressible, grayish, with some peripheral telangiectasia and pale peripheral halo, without palpable thrill or ulceration. Hemodynamically stable, without thrombocytopenia. The ultrasound and magnetic ressonance image suggested the clinical suspicion of RICH, which was supported by immunopathology. After 15 months there was a complete and spontaneous regression of the tumor.
Knowledge of the clinical presentation, evolution and prognosis of this rare hemangioma is crucial for the diagnosis and appropriate follow-up, avoiding unnecessary clinical interventions, and providing reassurance of caregivers.