The VASCERN-VASCA diagnostic and management pathways for kaposiform hemangioendothelioma

Eur J Pediatr. 2025 Dec 13;185(1):14. doi: 10.1007/s00431-025-06631-6.

Abstract

The European Reference Network (ERN) on Rare Multisystemic Vascular Diseases (VASCERN) is dedicated to gathering the best expertise in Europe in order to improve and provide high-level healthcare to all patients with rare vascular diseases and provide accessible cross-border healthcare to patients with rare vascular diseases. Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumour with local aggressiveness, often associated with a life-threatening coagulopathy known as the Kasabach-Merritt phenomenon (KMP). The Vascular Anomalies Working Group (VASCA-WG) developed diagnostic and therapeutic pathways for the management of KHE using the nominal group technique (NGT), a well-established, structured, multi-stage, facilitated group meeting technique used to generate consensus statements. The pathways were developed following two face-to-face meetings and several web meetings to facilitate discussion.

Conclusion: VASCA has produced this expert opinion, which reflects the strategies developed by experts and patient representatives on how to approach patients with Kaposiform Hemangiothelioma in a practical manner; here, we present an algorithmic flow chart of this work.

What is known: • Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor, often associated with a life threatening coagulopathy, and can be challenging to manage.

What is new: • The diagnostic and therapeutic pathway for KHE, developed by a multidisciplinary group of experts (VASCA-VASCERN Group), offers concrete offers concrete help in making decisions about managing this condition.

Keywords: Algorithm; Diagnosis; Kaposiform hemangioendothelioma; Kasabach-Merrit phenomenon; Patient pathway; Sirolimus; Treatment; Vascular tumour.

MeSH terms

  • Algorithms
  • Child
  • Critical Pathways*
  • Europe
  • Hemangioendothelioma* / diagnosis
  • Hemangioendothelioma* / therapy
  • Humans
  • Kasabach-Merritt Syndrome* / diagnosis
  • Kasabach-Merritt Syndrome* / therapy
  • Sarcoma, Kaposi* / diagnosis
  • Sarcoma, Kaposi* / therapy

Supplementary concepts

  • Kaposiform Hemangioendothelioma