Prenatal ultrasound diagnosis of congenital infantile fibrosarcoma and congenital hemangioma: Three case reports

BACKGROUND Congenital infantile fibrosarcoma(CIF)and congenital hemangioma(CH)have similarities on prenatal ultrasound and are rare.CASE SUMMARY We report 3 cases of fetuses with superficial hypervascular tumors,confirmed by postnatal pathology as CIF(1 case)and CH(2 cases,including 1 in a twin fetus).In Case 1,a mass with a rich blood supply in the fetal axilla was discovered by prenatal ultrasound at 28+0 wk of gestation.The postpartum pathological diagnosis was CIF,the mass was surgically removed,and the prognosis of the child was good.In Case 2,at 23+1 wk of gestation,a mass was discovered at the base of the fetus’s thigh on prenatal ultrasound.The postpartum pathological diagnosis was CH.After conservative treatment,the mass shrank significantly.Case 3 occurred in a twin fetus.At 30+0 wk of gestation,prenatal ultrasound revealed a bulging mass with a rich blood supply on the abdominal wall of one of the fetuses.Three weeks later,the affected fetus died,and the unaffected baby was successfully delivered by emergency cesarean section.The affected fetus was pathologically diagnosed with CH.CONCLUSION Prenatal ultrasound can provide accurate information,such as the location,size and blood supply of a surface mass in a fetus.We found similarities between CIF and CH in prenatal ultrasound findings.Although it is difficult to distinguish these conditions by prenatal ultrasound alone,for superficial hypervascular tumors that rapidly increase in size in a short period,close ultrasound monitoring of the fetus is required to quickly address possible adverse outcomes.

Preterm neonate with a large congenital hemangioma on maxillofacial site causing thrombocytopenia and heart failure:A case report

BACKGROUND We report a rare case of a large congenital hemangioma(CH)in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure.With close multidisciplinary collaboration,the congenital hemangioma was successfully resected with good results.CASE SUMMARY The patient was delivered at gestational age of 36 wk by cesarean section due to cephalopelvic disproportion and lack of onset of labor(birth weight:2630 g).A right-sided facial tumor was detected in the fetus during routine antenatal ultrasound examination of the mother at 32 wk of gestation.Physical examination revealed a 7 cm×7 cm×3 cm hard,dull purple-colored mass on the right maxillofacial region.The mass was tense and had prominent surface telangiectasias.Laboratory investigations revealed reduced hemoglobin and platelet count,and increased activated partial thromboplastin time,prothrombin time,and thrombin time.International normalized ratio,fibrin degradation products,and D-Dimer levels were significantly increased.Thromboelastography showed increased alpha angle,mean amplitude,and the clot formation speed.Thyroid-stimulating hormone level was significantly elevated.The patient was administered prednisone,propranolol,euthyrox,vitamin K1,milrinone,and digoxin.After operation,cefepime was administered for anti-infection and propranolol was prescribed at discharge.CONCLUSION We report a rare case of CH in the right maxillofacial region causing thrombocytopenia and heart failure.

Pediatric vascular tumors of the liver:Review from the pathologist’s point of view

Differential diagnosis of pediatric vascular liver tumors can be challenging due to inconsistent nomenclature,histologic overlap and the rarity of some entities.Here we give an up-to-date overview of the most important entities.We discuss the clinic,histology and pathophysiology of hepatic congenital and infantile heman-gioma,hepatic epithelioid hemangioendothelioma and hepatic angio-sarcoma.