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

doi:10.12998/wjcc.v10.i17.5756

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Jun 16, 2022; 10(17): 5756-5763
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5756

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

Neng Ren, Chun-Shun Jin, Xiao-Qi Zhao, Wen-Hui Gao, Yu-Xian Gao, Yuan Wang, Yun-Feng Zhang

Neng Ren, Xiao-Qi Zhao, Wen-Hui Gao, Yu-Xian Gao, Yuan Wang, Department of Neonatology, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China

Chun-Shun Jin, Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Jilin University, Changchun 130041, Jilin Province, China

Yun-Feng Zhang, Department of Pediatrics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China

Author contributions: Ren N was the doctor who was in charge of the patient and contributed to the manuscript drafting; Jin CS was the surgeon of the patient and contributed to the manuscript drafting; Zhao XQ and Gao WH analyzed and interpreted the imaging findings and contributed to the manuscript drafting; Gao YX was in charge of the care of the patient and contributed to the manuscript drafting; Wang Y participated in the process of treatment and contributed to the manuscript drafting; Zhang YF was the consultant of the patient and revised and reviewed the manuscript; all authors issued final approval for the version to be submitted.

Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Yun-Feng Zhang, DPhil, MD, PhD, Chief Doctor, Full Professor, Department of Pediatrics, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, Jilin Province, China. zhangyunf@jlu.edu.cn

Received: November 9, 2021
Peer-review started: November 9, 2021
First decision: December 27, 2021
Revised: January 4, 2022
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: June 16, 2022
Processing time: 212 Days and 7 Hours

Abstract

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.

Keywords: Congenital hemangioma; Maxillofacial site; Thrombocytopenia; Heart failure; Case report

Core Tip: The present report highlights the management strategy for congenital hemangiomas, i.e., protection of hemangioma before surgical resection, appropriate use of propranolol to contain the size and tension of the hemangioma, correction of anemia and thrombocytopenia, and improvement of congestive heart failure. Multidisciplinary collaboration is vital to achieve good outcomes.