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Congenital hemangiomas are rare vascular anomalies differentiated from classical hemangiomas of infancy by their appearance, evolution, and lack of GLUT-1 immunoreactivity. Two classical types based on their clinical course have been described, rapidly involuting congenital hemangioma (RICH) and Non-Involuting Congenital Hemangioma (NICH). Recently, the term Partially Involuting Congenital Hemangioma has been proposed (PICH) to refer to another subtype of hemangioma with different evolution. We present a case of a large vascular tumour on the right flank, causing complications on evolution as cardiac failure. Initially treated with propranolol without success, afterwards, when the patient presented a secondary heart failure, an embolization was necessary, and finally surgical treatment resolved the tumour. The giant forms of congenital hemangiomas were associated with RICH subtype, and usually its present transitory thrombocytopenia and coagulation abnormalities. According to our case and the published cases of giant congenital hemangiomas, we think that all these forms of giant congenital hemangiomas might be included in PICH group.

annals of case reports

Giant Congenital Hemangioma: An Entity of Intermediate Behavior Between Rapidly Involuting Congenital Hemangioma and Non-Involuting Congenital Hemangioma. Presentation of A Case and Review of the Literature