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An Infantile Bronchial Hemangioma Unresponsive to Propranolol Therapy:  Case Report and Literature Review

David I. Sierpina, BS; Hamad M. Chaudhary, BS; David L. Walner, MD; Gabriel Aljadeff, MD; Ira W. Dubrow, MD
Arch Otolaryngol Head Neck Surg. 2011;137(5):517-521. doi:10.1001/archoto.2011.67.
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Current options for treating airway hemangiomas include systemic and intralesional corticosteroids, interferon therapy, chemotherapy, use of lasers, open surgical excision, tracheotomy, sleeve resection, and selective artery embolization. The significant rates of complications described for these methods1,2 make the discovery of a novel therapy an attractive prospect. Several case reports and case series39 have recently appeared in the literature describing the use of propranolol as a highly effective option for the treatment of these airway lesions. Therefore, we reviewed the literature for information on the management of airway hemangiomas by performing a comprehensive PubMed search, focusing particularly on the use of propranolol in the treatment of airway hemangiomas, defined as occurring in the subglottis, trachea, and/or bronchi. We also describe a a 3-month-old boy with a large bronchial hemangioma that did not respond to propranolol therapy.

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Figure 1.

Cutaneous hemangioma at the time of presentation.

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Figure 2.

Coronal 3-dimensional computed tomogram with contrast obtained at the time of presentation showing an enhancing lesion in the left mainstem bronchus (arrow).

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Figure 3.

Bronchoscopic view obtained 10 days after admission showing 98% obstruction of the airway.

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Figure 4.

After 35 days of propranolol therapy, there was no reduction in the size of the hemangioma.

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