A 6-month-old boy is brought to the clinic for evaluation of a red lesion on his forehead. The mother of the child is concerned because the lesion has been rapidly increasing in size and the infant’s maternal grandmother died of melanoma in her 60s. On physical exam, a red, raised lesion about 1 cm × 3 cm with irregular borders can be seen about 3 cm superior to his left eyebrow. What is the best treatment option for this child?
- Do nothing
- Embolization
- Excision with wide margins
- Laser photocoagulation
- Systemic corticosteroid therapy
Pediatric Surgery/Vascular Tumors/Capillary Hemangiomas. This presentation is most consistent with a capillary hemangioma. These vascular tumors most often appear within the first few weeks of life and rapidly increase in size for about a year, after which they begin to spontaneously regress. Most of these hemangiomas, including the one in this question stem, should be left alone because they will most likely regress and pose no threat to the child’s health. Indications for intervention include lesions that threaten to interfere with the eyes or airway or lesions so large they cause thrombocytopenia, congestive heart failure, or significant facial distortion. All of the responses represent possible appropriate interventions, but this patient’s lesion does not currently require treatment of any kind.
(Thanks to the author&Publisher.Purpose of this post is to promote the students to buy such standard books for preparing when they want to appear for NEET 2014. )
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