Presentation and Evolution of Congenital Hepatic Hemangiomas

Research Article| September 01 2025 Presentation and Evolution of Congenital Hepatic Hemangiomas Available to Purchase AAP Grand Rounds (2025) 54 (3): 34. https://doi.org/10.1542/gr.54-3-34 Views Icon Views Open Menu Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook X LinkedIn Email Tools Icon Tools Open Menu Get Permissions Cite Icon Cite Search Site Citation Presentation and Evolution of Congenital Hepatic Hemangiomas. AAP Grand Rounds September 2025; 54 (3): 34. https://doi.org/10.1542/gr.54-3-34 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: hemangioma of liver Source: Ostertag-Hill CA, Fevurly RD, Kulungowski AM, et al. The natural history of congenital hepatic hemangiomas. J Pediatr. 2025;281:114523; doi: https://doi.org/10.1016/j.jpeds.2025.114523.Google Scholar Investigators from Boston Children's Hospital (BCH), conducted a retrospective study to describe the clinical presentation in children with congenital hepatic hemangioma (HH), assess rate of involution over time, and evaluate the impact of treatment on involution. Study patients were identified by reviewing the Vascular Anomalies Center database, which includes demographic, clinical, and radiographic data on patients with HH diagnosed at BCH or from other institutions through the use of an online registry. Standardized criteria, largely based on radiographic characteristics, were used to define congenital HH. Patients with infantile HH were excluded. The size of the congenital HH was estimated by reviewing imaging studies. Rank sum tests were used to evaluate the association between HH size at diagnosis and development of anemia (hemoglobin or hematocrit >2 standard deviations below mean), thrombocytopenia (platelets <150 x 109/L), congestive heart failure, and respiratory failure. To assess involution over time, data on infants with congenital HH who had sequential imaging studies available for review were included. Change in volume was assessed using regression analyses. Kaplan-Meier curve analysis was used to estimate rates of ≥50% involution at 12 and 24 months and compare involution rates in infants who received treatment for congenital HH or no treatment. A total of 96 infants with congenital HH were included in the analysis, with 37 (39%) diagnosed at BCH. Study participants had a median gestational age of 37 weeks and a median age at diagnosis of 1.0 day; 33 were diagnosed prenatally. Among those with available data, 23/48 (48%) patients had transient anemia and 30/53 (57%) had thrombocytopenia. The size of the HH at diagnosis was associated with an increased risk for anemia (P = 0.005), thrombocytopenia (P <0.001), and respiratory failure (P <0.001), but not congestive heart failure (P = 0.689). Sufficient radiographic information was available to assess change in size of the HH in 47 patients. At 12 and 24 months of age, the residual hemangioma volume was 43% and 16%, respectively. The rate of ≥50% involution was 79% (95% confidence interval [CI], 66, 89) at 12 months and 90% (95% CI, 78, 97) at 24 months. There were 39 (46%) infants who received treatment for congenital HH. There was no significant difference in the rate of involution between patients receiving treatment or no treatment (P = 0.84). The mortality rate of participants with available data was 4% (3/72), with 1 death related to the congenital HH. The authors conclude that in infants with congenital HH, mean involution over 24 months was >80%. Dr Doolittle has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Congenital HH, although rare, is the most common hepatic tumor in infancy.1 Management of HH varies... You do not currently have access to this content.