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      Vascular tumors in infants and adolescents

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          Abstract

          Malignant vascular tumors as part of the vascular anomalies spectrum are extremely rare in children and young adults. Instead, benign vascular neoplasias are frequently encountered in the pediatric patient population. While vascular malformations are congenital vascular lesions, originating from a mesenchymal stem cell defect, vascular tumors are neoplastic transformations of endothelial and other vascular cells. The appropriate differential diagnosis and nomenclature according to the classification of the International Society for the Study of Vascular Anomalies (ISSVA) is decisive to initiate correct therapy. While infantile hemangioma can be routinely diagnosed by clinical means and rarely require therapy, more rare vascular tumors are frequently difficult to diagnose, require dedicated cross-sectional imaging, and benefit from an interdisciplinary treatment approach. The focus of this review is to provide an overview over the spectrum of vascular tumors, typical imaging characteristics, and summarize treatment options including interventional radiology approaches.

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          Most cited references69

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          Angiosarcoma.

          Angiosarcomas are rare soft-tissue sarcomas of endothelial cell origin that have a poor prognosis. They can arise anywhere in the body, most commonly presenting as cutaneous disease in elderly white men, involving the head and neck and particularly the scalp. They can be caused by therapeutic radiation or chronic lymphoedema and hence secondary breast angiosarcomas are an important subgroup. Recent work has sought to establish the molecular biology of angiosarcomas and identify specific targets for treatment. Interest is now focused on trials of vascular-targeted drugs, which are showing promise in the control of angiosarcomas. In this review we discuss angiosarcoma and its current management, with a focus on clinical trials investigating the treatment of advanced disease. Copyright © 2010 Elsevier Ltd. All rights reserved.
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            A randomized, controlled trial of oral propranolol in infantile hemangioma.

            Oral propranolol has been used to treat complicated infantile hemangiomas, although data from randomized, controlled trials to inform its use are limited.
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              Infantile haemangioma.

              With a prevalence of 4·5%, infantile haemangiomas are the most common benign tumours of infancy, arising in the first few weeks of life and exhibiting a characteristic sequence of growth and spontaneous involution. Most infantile haemangiomas do not require therapy. However, to identify at-risk haemangiomas, close follow-up is crucial in the first weeks of life; 80% of all haemangiomas reach their final size by 3 months of age. The main indications for treatment are life-threatening infantile haemangioma (causing heart failure or respiratory distress), tumours posing functional risks (eg, visual obstruction, amblyopia, or feeding difficulties), ulceration, and severe anatomic distortion, especially on the face. Oral propranolol is now the first-line treatment, which should be administered as early as possible to avoid potential complications. Haemangioma shrinkage is rapidly observed with oral propranolol, but a minimum of 6 months of therapy is recommended.
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                Author and article information

                Contributors
                +49 251 83 56261 , moritz.wildgruber@ukmuenster.de
                Journal
                Insights Imaging
                Insights Imaging
                Insights into Imaging
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1869-4101
                13 March 2019
                13 March 2019
                December 2019
                : 10
                : 30
                Affiliations
                [1 ]ISNI 0000 0004 0551 4246, GRID grid.16149.3b, Institut für Klinische Radiologie, , Universitätsklinikum Münster, ; Albert-Schweitzer Campus 1, 48149 Münster, Germany
                [2 ]ISNI 0000 0001 2162 1728, GRID grid.411778.c, Institut für Klinische Radiologie und Nuklearmedizin, , Universitätsmedizin Mannheim, ; Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
                [3 ]ISNI 0000 0001 0482 5331, GRID grid.411984.1, Institut für Diagnostische und Interventionelle Radiologie, , Universitätsmedizin Göttingen, ; Robert-Koch Strasse 40, 37075 Göttingen, Germany
                [4 ]Universitätsklinik und Poliklinik für Radiologie, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany
                Article
                718
                10.1186/s13244-019-0718-6
                6419671
                30868300
                a75aece0-8be4-44cd-b117-8e0b13df3991
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 6 November 2018
                : 12 February 2019
                Categories
                Review
                Custom metadata
                © The Author(s) 2019

                Radiology & Imaging
                vascular anomalies,vascular tumor,hemangioma,imaging
                Radiology & Imaging
                vascular anomalies, vascular tumor, hemangioma, imaging

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