Salvatore Vendemmia - Aversa, Ilaria Pezone - Aversa, Merih Cetinkaya -Istanbul, Caterina Russo - Rome, Maria Vendemmia - Naples
INTRODUCTION
Infantile hemangioma is a very common pathology, and in the neonatal period it affects 5/10% of newborns, within the first year of life [1]. In truth it is very often found in the first weeks of life.
It presents as a detected vascular lesion, hyperplastic, red or purple in color. It can happen that deeper lesions are not detectable immediately after birth.
Generally, vascularization and size increase rapidly in volume, and within the third month of life of the affected subject, they can increase in size by up to eighty percent. Most deep hemangiomas grow very rapidly diameter, and such rapid increase can hinder many functions [2].
In fact, those that hinder vision, airways or other structures require urgent treatment, and specific and ideal treatment varies based on specific characteristics of the new formation and the patient.
CLASSIFICATION and SYMPTOMATOLOGY
In reference to their general characteristics, we distinguish a superficial, cavernous, deep, strawberry shape. The skin shapes have an appearance that varies, depending on the depth: the superficial ones are bright red in colour, and the deep ones are bluish. They can disturb regular physiological functions, in relation to the location in which are located. Those on the face or in the oropharynx can obstruct respiratory function or create visual problems, those near the anus or urethral meatus can hinder regular outflow.
CLINICAL CASE
Three-month-old girl in good general health. From an anamnestic point of view, the mother reports that, since the second month of her daughter's life, she has noticed a slight "swelling" in the left sub clavicular area. He also argues that this training has rapidly increased, and that in about a month, its extension has doubled. Upon observation, a notable swelling is noted which extends from the lower margin of the left clavicle towards the left mammary areola. The swelling is angiomatous in appearance and has a hard-elastic consistency, mobile and easily movable on the underlying surfaces, and is not painful. It clearly shows tortuous vascularization. An "eye" assessment it suggests that the mass has a length of at least 4 cm and a width of approximately 2-3 cm. We made the diagnosis of haemangioma and performed a regional ultrasound. The ultrasound result was as follows: " Affecting the upper side of the left breast solid ovarian formation ,isoechoic, with diameters 35x12 mm, with wavy but well-shaped margins, with internal echo structure finely inhomogeneous due to the presence of vascular structures that show normal resistance indices and which do not appear compressed or infiltrated . This formation shows no sound absorption or signs of infiltration of the underlying muscle region. Find attributable, in the first hypothesis, to "haemangioma”.
CONCLUSIONS
An urgent evaluation is essential because these pathologies present a "PEAK PROLIFERATIVE PHASE" that occurs between the first and fifth month of life. In this era, infantile forms of hemangiomas grow with unprecedented speed, and their expansion must be immediately stopped before it can cause structural damage. Furthermore, uncontrolled growth in the mammary region can damage the developing mammary gland and cause permanent asymmetries. Finally, it must be remembered that the rapid growth of the new formation, holds the skin is very tense and, for this reason, may present ulcerations, excoriations, bleeding and infections.
BIBLIOGRAFIA
[1] Lèautè-Lebrèzec Preys , Ezzedine K. INFANTILE HAEMANGIOMA. J. Eur. Acad. Dermat. Ven , 2011; 25 : 1245-53
[2] Greenberger S, Bischoff J. PATHOGENESIS OF INFANTILE HEMANGIOMA. Br. J. Dermatology, 2013, 169 (1 ) : 12-9