Purpose or Case Report: Soft tissue hemangiomas (STH) are the most common benign vascular tumors in childhood. Its diagnosis is mainly clinical. In some cases, imaging is required, US Doppler choice of preference. Less frequently, it can be complemented with complex studies such as diagnostic angiography, MRI and biopsy, or ultrasonographic follow-up.
This study aims to investigate the characteristics of STH that required imaging follow-up, complex studies or biopsies.
Methods & Materials: Retrospective, descriptive, observational, non-experimental study with patients under 15 years of age studied with US between 2015 and 2021. 107 patients with imaging follow-up were selected. Data were collected from the medical report, medical orders and clinical records. STATA software was used for statistical analysis.
Results: The average age of the first US is 2.4 years, 76% female. 64% were infantile hemangiomas, with a focal pattern in 81%. 91% showed deep compromise. Its most frequent location (57%) was head and neck and 36% had a location with functional compromise. US allows us to identify atypical findings (15 patients) and suggest alternative diagnoses.
Follow-up was performed with US in 94%. Only 6% required MRI as a complementary study, the indication of which was the association with syndromes and functional compromise.
4 patients required biopsied. In 3 cases the indication for biopsy was due to atypical evolution with long-term follow-up with US. The follow-up period is shortened when atypical US findings with atypical evolution are added. In this case the biopsy was not concordant with a vascular anomaly.
Conclusions: US is the study of choice in STH, both to characterize and confirm the lesion and to perform follow-up.
The use of MRI was related to functional compromise and syndromic symptoms.
When we identify atypical findings on US or there is discordance with its evolutionary stage, radiologists must suggest follow-up with US in the first instance, propose differential diagnoses and perform a biopsy.