Chemotherapy and surgical approach with repeated endovascular embolizations: Safe interdisciplinary treatment for kasabach-merritt syndrome in a small baby

Ghassan Nakib, Valeria Calcaterra, Pietro Quaretti, Lorenzo Paolo Moramarco, Giovanni Bonalumi, Marco Brunero, Gloria Pelizzo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Kasabach-Merritt syndrome (KMS) is a life-threatening disease. We describe a combined medical and multistep, endovascular embolization that was successfully performed with surgery. Case Report: A 40-day-old female baby was referred because of an infiltrating pelvic mass. Blood tests showed severe anemia and thrombocytopenia with consumptive coagulopathy. The clinical aspect was pathognomonic for KMS. Administration of steroids and chemotherapy were started and coagulation parameters were normalized with tumor volume regression. Three months later, elective surgical treatment became possible, and dissection and ligature of the left internal iliac artery and sacral artery were performed. The main arterial supply of the mass was embolized with Spongostan®. Two months later, a second hybrid approach was adopted for embolization of the main vascular supply of the tumor occupying the left thigh. Via a third contralateral hybrid femoral approach and under fluoroscopy, selective catheterization of the left profunda femoris artery was performed. The arterial feeder of the tumor, localized at the left gluteus, was seen on a CT scan 2 months later and was embolized with Onyx-18. Conclusion: Chemotherapy and a tailored hybrid approach comprising repeated endovascular embolizations seem to be a safe treatment in cases of unresectable and life-threatening tumors in small babies.

Original languageEnglish
Pages (from-to)23-28
Number of pages6
JournalCase Reports in Oncology
Volume7
Issue number1
DOIs
Publication statusPublished - 2014

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Kasabach-Merritt Syndrome
Thigh
Drug Therapy
Fibrin Foam
Arteries
Neoplasms
Iliac Artery
Fluoroscopy
Hematologic Tests
Tumor Burden
Catheterization
Thrombocytopenia
Ligation
Blood Vessels
Dissection
Anemia
Therapeutics
Steroids

Keywords

  • Endovascular embolization
  • Kaposiform hemangioendothelioma
  • Kasabach-Merritt syndrome
  • Onyx-18

ASJC Scopus subject areas

  • Oncology

Cite this

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title = "Chemotherapy and surgical approach with repeated endovascular embolizations: Safe interdisciplinary treatment for kasabach-merritt syndrome in a small baby",
abstract = "Introduction: Kasabach-Merritt syndrome (KMS) is a life-threatening disease. We describe a combined medical and multistep, endovascular embolization that was successfully performed with surgery. Case Report: A 40-day-old female baby was referred because of an infiltrating pelvic mass. Blood tests showed severe anemia and thrombocytopenia with consumptive coagulopathy. The clinical aspect was pathognomonic for KMS. Administration of steroids and chemotherapy were started and coagulation parameters were normalized with tumor volume regression. Three months later, elective surgical treatment became possible, and dissection and ligature of the left internal iliac artery and sacral artery were performed. The main arterial supply of the mass was embolized with Spongostan{\circledR}. Two months later, a second hybrid approach was adopted for embolization of the main vascular supply of the tumor occupying the left thigh. Via a third contralateral hybrid femoral approach and under fluoroscopy, selective catheterization of the left profunda femoris artery was performed. The arterial feeder of the tumor, localized at the left gluteus, was seen on a CT scan 2 months later and was embolized with Onyx-18. Conclusion: Chemotherapy and a tailored hybrid approach comprising repeated endovascular embolizations seem to be a safe treatment in cases of unresectable and life-threatening tumors in small babies.",
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author = "Ghassan Nakib and Valeria Calcaterra and Pietro Quaretti and Moramarco, {Lorenzo Paolo} and Giovanni Bonalumi and Marco Brunero and Gloria Pelizzo",
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AU - Nakib, Ghassan

AU - Calcaterra, Valeria

AU - Quaretti, Pietro

AU - Moramarco, Lorenzo Paolo

AU - Bonalumi, Giovanni

AU - Brunero, Marco

AU - Pelizzo, Gloria

PY - 2014

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N2 - Introduction: Kasabach-Merritt syndrome (KMS) is a life-threatening disease. We describe a combined medical and multistep, endovascular embolization that was successfully performed with surgery. Case Report: A 40-day-old female baby was referred because of an infiltrating pelvic mass. Blood tests showed severe anemia and thrombocytopenia with consumptive coagulopathy. The clinical aspect was pathognomonic for KMS. Administration of steroids and chemotherapy were started and coagulation parameters were normalized with tumor volume regression. Three months later, elective surgical treatment became possible, and dissection and ligature of the left internal iliac artery and sacral artery were performed. The main arterial supply of the mass was embolized with Spongostan®. Two months later, a second hybrid approach was adopted for embolization of the main vascular supply of the tumor occupying the left thigh. Via a third contralateral hybrid femoral approach and under fluoroscopy, selective catheterization of the left profunda femoris artery was performed. The arterial feeder of the tumor, localized at the left gluteus, was seen on a CT scan 2 months later and was embolized with Onyx-18. Conclusion: Chemotherapy and a tailored hybrid approach comprising repeated endovascular embolizations seem to be a safe treatment in cases of unresectable and life-threatening tumors in small babies.

AB - Introduction: Kasabach-Merritt syndrome (KMS) is a life-threatening disease. We describe a combined medical and multistep, endovascular embolization that was successfully performed with surgery. Case Report: A 40-day-old female baby was referred because of an infiltrating pelvic mass. Blood tests showed severe anemia and thrombocytopenia with consumptive coagulopathy. The clinical aspect was pathognomonic for KMS. Administration of steroids and chemotherapy were started and coagulation parameters were normalized with tumor volume regression. Three months later, elective surgical treatment became possible, and dissection and ligature of the left internal iliac artery and sacral artery were performed. The main arterial supply of the mass was embolized with Spongostan®. Two months later, a second hybrid approach was adopted for embolization of the main vascular supply of the tumor occupying the left thigh. Via a third contralateral hybrid femoral approach and under fluoroscopy, selective catheterization of the left profunda femoris artery was performed. The arterial feeder of the tumor, localized at the left gluteus, was seen on a CT scan 2 months later and was embolized with Onyx-18. Conclusion: Chemotherapy and a tailored hybrid approach comprising repeated endovascular embolizations seem to be a safe treatment in cases of unresectable and life-threatening tumors in small babies.

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