Isolated subglottic hemangiomas: A potential diagnostic challenge in the absence of a cutaneous clue

Publication Date

2015

Journal Title

Am J Otolaryngol

Abstract

Objective: Subglottic hemangiomas may present a diagnostic challenge in the stridorous infant without a cutaneous lesion. Methods: Consecutive case series with chart review of isolated subglottic hemangiomas without cutaneous lesions. Results: Two patients with isolated subglottic hemangiomas without cutaneous lesions were identified. Both patients presented with stridor and were initially treated with systemic corticosteroids, racemic epinephrine, and supportive medical therapy for a presumed infectious etiology. After failure to clinically improve over an expected period of time, endoscopy was performed. Propranolol was initiated immediately after the diagnosis was made. Clinical response was noted in the first 24 hours after administration. Both children were able to be safely titrated up to the therapeutic dose (2 mg/kg/day). No complications or re-admissions were encountered. Conclusions: Clinical suspicion for a subglottic hemangioma in an infant with stridor may be high in cases where there is a synchronous cutaneous lesion. In infants without cutaneous involvement, diagnosis may be delayed and more challenging, given the possibility of an infectious etiology. These infants without a synchronous cutaneous lesion tend to present at an older age than infants with cutaneous lesions and may be managed successfully with propranolol. (C) 2015 Elsevier Inc. All rights reserved.

Volume Number

36

Issue Number

3

Pages

399-401

Document Type

Article

EPub Date

2015/02/11

Status

Faculty

Facility

School of Medicine

Primary Department

Otolaryngology

Additional Departments

Pediatrics

PMID

25659918

DOI

10.1016/j.amjoto.2015.01.011

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