Clinical features of rapid involuting congenital hemangioma: a prospective study

Rapid involuting congenital hemangiomas (RICHs) are rare benign tumors that occur in infancy. We conducted a prospective study to evaluate the clinical characteristics, complications, requirements for therapeutic intervention, and sequelae in patients with RICHs. Eligible patients were ≤7 days old and had RICH. The primary endpoint was the time of complete involution of RICH. Eighty-six patients were included. The involution of RICH was nonlinear. All RICH patients had signs of involution within 4 weeks of age. The time of greatest involution was between 1.3 months and 2.3 months, with a mean complete involution occurring at 10.1 months. In total, 5.8% of patients experienced complications caused by or possibly related to RICH, and only 1.2% received some form of early treatment during the study period. Severe/significant sequelae was observed in 18.6% of subjects. The location of head-face-neck was the only risk factor that predicted severe/significant sequelae (odds ratio: 4.673; 95% confidence interval: 1.326-16.667; P=0.016). RICH exhibits rapid regression within the first few months of life. Although clinical observation is recommended in patients with RICH, some lesions may leave severe/significant sequelae, especially those involving the head-face-neck area.快速消退型先天性血管瘤（Rapid involuting congenital hemangiomas, RICHs）是一类罕见的婴幼儿良性肿瘤。本研究开展前瞻性研究，旨在评估RICH患者的临床特征、并发症、治疗干预需求及后遗症情况。入组患者均为出生后7天内且确诊RICH的婴儿。本研究的主要终点为RICH完全消退的时间。本研究共纳入86例患者。结果显示，RICH的消退过程呈非线性特征：所有患者均在出生后4周内出现消退迹象，最快消退阶段集中于出生后1.3~2.3个月，平均完全消退时间为10.1个月。总计5.8%的患者出现了由RICH引发或可能相关的并发症，研究期间仅1.2%的患者接受了早期治疗。另有18.6%的受试者出现了严重/显著后遗症。头面颈部部位是预测严重/显著后遗症的唯一危险因素（比值比：4.673；95%置信区间：1.326~16.667；P=0.016）。RICH在出生后最初数月内可快速消退。尽管目前推荐对RICH患者采取临床观察策略，但部分病灶可能遗留严重/显著后遗症，尤其是位于头面颈部区域的病变。