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Case Records of the Massachusetts General Hospital
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Volume 350:1764-1775 April 22, 2004 Number 17
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Case 13-2004 — A Newborn Girl with a Large Cutaneous Lesion, Thrombocytopenia, and Anemia
John B. Mulliken, M.D., Sudha Anupindi, M.D., R. Alan B. Ezekowitz, M.B., Ch.B., D.Phil., and Martin C. Mihm, Jr., M.D.

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Presentation of Case

A newborn girl was transferred to this hospital because of a large cutaneous lesion, thrombocytopenia, and anemia.

The infant had been born at another hospital to a 33-year-old woman (gravida 2, para 1). She was delivered by cesarean section at 37 weeks' gestation. The Apgar scores were 9 at one minute and 9 at five minutes. The weight was 2470 g. A large, dark-red cutaneous lesion, 2.5 mm thick, covered much of the child's right hemithorax. Physical examination disclosed no other abnormalities. The oxygen saturation was 84 percent while the infant breathed ambient air. She was placed in a hood . . . [Full Text of this Article]

Differential Diagnosis

Distinction between Kaposiform Hemangioendothelioma and Infantile Hemangioma

Other Congenital Vascular and Nonvascular Lesions

Abnormalities in Coagulation Associated with Vascular Lesions

Other Vascular Tumors Associated with the Kasabach–Merritt Phenomenon

Clinical Diagnosis

Dr. John B. Mulliken's Diagnosis

Pathological Discussion

Final Diagnosis

Discussion of Management

Thrombocytopenia in Infants with the Kasabach–Merritt Phenomenon

Treatment of Kaposiform Hemangioendothelioma

Mortality and Morbidity


Source Information

From the Division of Plastic Surgery, Craniofacial Center, and Vascular Anomalies Center, Children's Hospital (J.B.M.); the Department of Radiology (S.A.), Pediatric Service (R.A.B.E.), and the Department of Pathology, Division of Dermatopathology (M.C.M.), Massachusetts General Hospital; and the Departments of Surgery (J.B.M.), Radiology (S.A.), Pediatrics (R.A.B.E.), and Dermatology (M.C.M.), Harvard Medical School — all in Boston.


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