A case of infantile hemangioma with congenital portosystemic shunt

Abstract

A case of infantile hemangioma complicated with congenital portosystemic shunt is reported. A 2-month and 7-day-old boy presented with scattered red skin lesions and yellowish skin for over 2 months, and aggravated for 1 week. The dermatology examination revealed about 54 scattered red and dark red plaques of various sizes with a soft texture and clear boundaries. Abdominal ultrasound showed hyperechoic nodules (1 cm×0.8 cm) in the right lobe of the liver and enlarged spleen with heterogeneous echogenic nodules, along with multiple vascular branches between the middle hepatic vein and the sagittal portal vein, in which blue blood flow signal was visible. CT of the upper abdomen showed multiple irregular low-density shadows in the liver, and the lesions were significantly enhanced on the enhancement scan, and large blood vessels were visible in the lesions. Diagnosis: Infantile hemangioma; Congenital portosystemic shunt complicated with arteriovenous fistula; Cytomegalovirus disease. After treatment with oral propranolol, the cutaneous hemangioma almost completely subsided and the CPSS branches were closed. The child grew and developed normally during a 1-year follow-up.

Keywords

• infantile hemangiomas
• congenital portosystemic shunts
• propranolol
• ultrasound