Partially involuting congenital hemangiomas: a report of 8 cases and review of the literature

J Am Acad Dermatol. 2014 Jan;70(1):75-9. doi: 10.1016/j.jaad.2013.09.018. Epub 2013 Oct 29.

Abstract

Background: Congenital hemangiomas have been divided into 2 major subtypes based on clinical behavior: rapidly involuting congenital hemangioma (RICH) and noninvoluting congenital hemangioma (NICH).

Objective: We describe a clinical subtype of congenital hemangioma that begins as a RICH but fails to completely involute and persists as a NICH-like lesion. We propose the term "partially involuting congenital hemangioma" for this lesion with overlapping features.

Methods: A review of the medical charts, serial clinical photographs, imaging, and biopsies performed on children with a diagnosis of partially involuting congenital hemangioma between 2001 and 2012 at Centre Hospitalier Universitaire Sainte-Justine pediatric dermatology/vascular anomalies clinic was performed.

Results: Eight full-term, healthy infants presented at birth with vascular lesions typical of RICH. Affected locations included the head and neck, trunk, or extremities. Size varied from 2.0 × 1.5 cm to 13.0 × 8.5 cm. All had rapid involution during the first 12 to 30 months of life before stabilizing in size and appearance.

Limitations: Only a small number of cases were identified.

Conclusion: Partially involuting congenital hemangiomas are congenital hemangiomas with a distinct behavior, evolving from RICH to persistent NICH-like lesions. Their recognition and study will help us better understand whether RICH and NICH are indeed separate entities or simply part of a spectrum.

Keywords: infantile hemangioma; noninvoluting congenital hemangioma; partially involuting congenital hemangioma; rapidly involuting congenital hemangioma.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Child
  • Child, Preschool
  • Female
  • Hemangioma / congenital*
  • Hemangioma / diagnostic imaging
  • Hemangioma / pathology*
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Skin Neoplasms / congenital*
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / pathology*
  • Ultrasonography