An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including...An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including transfusion of blood products and clotting factors,were administered to reverse fatal disseminated intravascular coagulation and acute hemolysis.The glucocorticoid dose was tapered slowly,and sirolimus was added to treat the hemangiomas.The patient subsequently underwent interventional therapy.After 6 months of medical and interventional therapy,the patient was doing well with a normal platelet count,the tumor volume was markedly reduced,and the primary cutaneous lesion became pale pink.Currently,the patient remains on sirolimus,and no recurrence of thrombocytopenia or further growth of the mass was observed after six months of follow-up.展开更多
Kaposiform hemangioendothelioma （KHE） is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the Kasabach-Meritt phenomenon which is marked by...Kaposiform hemangioendothelioma （KHE） is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the Kasabach-Meritt phenomenon which is marked by severe thrombocytopenia and a variable degree of anemia. The tumor mostly is located in the superficial or deep soft tissue mass of the extremities. Herein, we report an unusual case of kaposiform hemangioendothelioma that,展开更多
Case Report A 36-year-old man with a neoplasm in his right-leg had undergone surgical removal of this neoplasm at an out-patient clinic (OPD). The tumor size was about 1 cm×1 cm×0.5 cm. It was knotty and non...Case Report A 36-year-old man with a neoplasm in his right-leg had undergone surgical removal of this neoplasm at an out-patient clinic (OPD). The tumor size was about 1 cm×1 cm×0.5 cm. It was knotty and nonencapsulated. Its cross-section was kermesinus and its texture was moderate. The pathological examination confirmed a diagnosis of Kaposiform hemangioendothelioma.展开更多
Introduction The Kasabach–Merritt phenomenon(KMP)is a severe complication of kaposiform hemangioendothelioma(KHE).The risk factors for KMP need further investigation.Methods The medical records of patients with KHE w...Introduction The Kasabach–Merritt phenomenon(KMP)is a severe complication of kaposiform hemangioendothelioma(KHE).The risk factors for KMP need further investigation.Methods The medical records of patients with KHE were reviewed.Univariate and multivariate logistic regression models were used for the risk factors for KMP,and the area under the receiver operator characteristic(ROC)curve was used to assess the predictive power of risk factors.Results A total of 338 patients with KHE were enrolled.The incidence of KMP was 45.9%.Age of onset(P<0.001,odds ratio[OR]0.939;95%confidence interval[CI]0.914–0.966),lesion size(P<0.001,OR 1.944;95%CI 1.646–2.296),mixed type(P=0.030,OR 2.428;95%CI 1.092–5.397),deep type(P=0.010,OR 4.006;95%CI 1.389–11.556),and mediastinal or retroperitoneal lesion location(P=0.019,OR 11.864;95%CI 1.497–94.003)were correlated with KMP occurrence through multivariate logistic regression.ROC curve analysis revealed that the optimal cutoffs were 4.75 months for the age of onset(P<0.001,OR 7.206,95%CI 4.073–12.749)and a lesion diameter of 5.35 cm(P<0.001,OR 11.817,95%CI 7.084–19.714).Bounded by a lesion size of 5.35 cm,we found significant differences in tumor morphology,age of onset,treatments,and hematological parameters.Using an onset age of 4.75 months as a cutoff,we found significant differences in tumor morphology,lesion size,hematological parameters,and prognosis.Conclusion For KHE patients with an onset age<4.75 months and/or lesion diameter>5.35 cm,clinicians should be wary of the occurrence of KMP.Active management is recommended to improve the prognosis.展开更多
Background Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor affecting infants and young children. Although benign, it can be associated with an aggressive locally growing tumor and/or a life-threatening ...Background Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor affecting infants and young children. Although benign, it can be associated with an aggressive locally growing tumor and/or a life-threatening Kasabach–Merritt phenomenon (KMP). To date, only reviews of limited cases have been performed. We, therefore, conducted a comprehensive literature search to collect relevant data and make recommendations for future treatment trials. Methods Review of the available literature between 1993 and 2017 revealed a total of 105 publications involving 215 patients of less than 21 years of age. To this, we added 12 from our department and 4 from the Cooperative Weichteilsarkomstudie database. Results We found that KMP was present in 79% of the infants, in 47% of the 1–5-year olds, in 43% of the 6–12-year olds, and in 10% of the 13–21-year-old patients. KMP was present in nearly all (94%) patients with retroperitoneal tumors and in all patients with extra-regional tumors. The median size of a KHE without KMP was 12 cm2 as compared to 49 cm2 when associated with a KMP. With complete (not further classifiable if R0 or R1) resection, all patients were cured. If inoperable, response regarding KMP/regression of tumor size was seen in 29/28% with steroid-, 47/39% with vincristine-, 44/43% with interferon alpha-, 65/61% with anti-platelet agents-, and in 97/100% with sirolimus-containing therapies. Conclusions Patients with progressive KHE should undergo resection whenever it is considered a safe option. If inoperable, sirolimus should be the first choice for treating KMP and reducing tumor size.展开更多
文摘An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including transfusion of blood products and clotting factors,were administered to reverse fatal disseminated intravascular coagulation and acute hemolysis.The glucocorticoid dose was tapered slowly,and sirolimus was added to treat the hemangiomas.The patient subsequently underwent interventional therapy.After 6 months of medical and interventional therapy,the patient was doing well with a normal platelet count,the tumor volume was markedly reduced,and the primary cutaneous lesion became pale pink.Currently,the patient remains on sirolimus,and no recurrence of thrombocytopenia or further growth of the mass was observed after six months of follow-up.
文摘Kaposiform hemangioendothelioma （KHE） is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the Kasabach-Meritt phenomenon which is marked by severe thrombocytopenia and a variable degree of anemia. The tumor mostly is located in the superficial or deep soft tissue mass of the extremities. Herein, we report an unusual case of kaposiform hemangioendothelioma that,
文摘Case Report A 36-year-old man with a neoplasm in his right-leg had undergone surgical removal of this neoplasm at an out-patient clinic (OPD). The tumor size was about 1 cm×1 cm×0.5 cm. It was knotty and nonencapsulated. Its cross-section was kermesinus and its texture was moderate. The pathological examination confirmed a diagnosis of Kaposiform hemangioendothelioma.
基金supported by the National Natural Science Foundation of China(Grant No.82273556)the Key Project in the Science&Technology Program of Sichuan Province(Grants No.2022YFS0233,2022YFS0225,and 2022NSFSC1480)+3 种基金the Project of‘0 to 1’of Sichuan University(Grant No.2022SCUH0033)the MedX Center for Informatics Funding Project(Grant No.YGJC004)the 1·3·5 Project for Disciplines of Excellence-Clinical Research Incubation Project of West China Hospital of Sichuan University(Grants No.2019HXFH056 and 2020HXFH048)the 1·3·5 Project for Disciplines of Excellence-Clinical Research Interdisciplinary Innovation Project of West China Hospital of Sichuan University(Grant No.ZYJC21060).
文摘Introduction The Kasabach–Merritt phenomenon(KMP)is a severe complication of kaposiform hemangioendothelioma(KHE).The risk factors for KMP need further investigation.Methods The medical records of patients with KHE were reviewed.Univariate and multivariate logistic regression models were used for the risk factors for KMP,and the area under the receiver operator characteristic(ROC)curve was used to assess the predictive power of risk factors.Results A total of 338 patients with KHE were enrolled.The incidence of KMP was 45.9%.Age of onset(P<0.001,odds ratio[OR]0.939;95%confidence interval[CI]0.914–0.966),lesion size(P<0.001,OR 1.944;95%CI 1.646–2.296),mixed type(P=0.030,OR 2.428;95%CI 1.092–5.397),deep type(P=0.010,OR 4.006;95%CI 1.389–11.556),and mediastinal or retroperitoneal lesion location(P=0.019,OR 11.864;95%CI 1.497–94.003)were correlated with KMP occurrence through multivariate logistic regression.ROC curve analysis revealed that the optimal cutoffs were 4.75 months for the age of onset(P<0.001,OR 7.206,95%CI 4.073–12.749)and a lesion diameter of 5.35 cm(P<0.001,OR 11.817,95%CI 7.084–19.714).Bounded by a lesion size of 5.35 cm,we found significant differences in tumor morphology,age of onset,treatments,and hematological parameters.Using an onset age of 4.75 months as a cutoff,we found significant differences in tumor morphology,lesion size,hematological parameters,and prognosis.Conclusion For KHE patients with an onset age<4.75 months and/or lesion diameter>5.35 cm,clinicians should be wary of the occurrence of KMP.Active management is recommended to improve the prognosis.
文摘Background Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor affecting infants and young children. Although benign, it can be associated with an aggressive locally growing tumor and/or a life-threatening Kasabach–Merritt phenomenon (KMP). To date, only reviews of limited cases have been performed. We, therefore, conducted a comprehensive literature search to collect relevant data and make recommendations for future treatment trials. Methods Review of the available literature between 1993 and 2017 revealed a total of 105 publications involving 215 patients of less than 21 years of age. To this, we added 12 from our department and 4 from the Cooperative Weichteilsarkomstudie database. Results We found that KMP was present in 79% of the infants, in 47% of the 1–5-year olds, in 43% of the 6–12-year olds, and in 10% of the 13–21-year-old patients. KMP was present in nearly all (94%) patients with retroperitoneal tumors and in all patients with extra-regional tumors. The median size of a KHE without KMP was 12 cm2 as compared to 49 cm2 when associated with a KMP. With complete (not further classifiable if R0 or R1) resection, all patients were cured. If inoperable, response regarding KMP/regression of tumor size was seen in 29/28% with steroid-, 47/39% with vincristine-, 44/43% with interferon alpha-, 65/61% with anti-platelet agents-, and in 97/100% with sirolimus-containing therapies. Conclusions Patients with progressive KHE should undergo resection whenever it is considered a safe option. If inoperable, sirolimus should be the first choice for treating KMP and reducing tumor size.
