Treatment of hemangioma in pediatric patients. [portuguese]

Hemangiomas, the most common type of tumor in children, are the result of the proliferation of blood vessels. The evolution is typical: lesions start out barely visible but grow very quickly during the first months of life (proliferative stage). They eventually stabilize, then regress spontaneously sometime between 3 and 9 years of age. However, large hemangiomas may last well into adolescence and produce significant scars. Approximately 24% of children with hemangiomas experience complications and require treatment. The first choice is systemic corticoid therapy (effective in 90% of cases) but high doses and prolonged treatment (>3 months) are necessary, most patients respond only partially and adverse effects are common. Interferon alfa and vincristine have been shown to be effective in limited series, but progress is slow and side effects can be severe. Recently introduced, treatment with propranolol at normal concentrations is reported to produce excellent short and mid-term results. Due to its good safety profile, some authors indicate propranolol as the first choice in the treatment of complicated hemangiomas in children.