A-3 month-old girl diagnosed with infantile hemangioma by Pediatrician and received oral propranolol which did not work. At that time, she was referred to the dermatology clinic and we clinically diagnosed it tufted angioma and recommended interferon ...
A-3 month-old girl diagnosed with infantile hemangioma by Pediatrician and received oral propranolol which did not work. At that time, she was referred to the dermatology clinic and we clinically diagnosed it tufted angioma and recommended interferon alpha 2 injection. Pediatrician did sono-guided gun biopsy and the pathology report was suspicious kaposiform hemangioendothelioma. After gun biopsy, her platelet count was decreased until 55K, and she was thought to be developed Kasabach-Merritt syndrome (KMS). She admitted to Pediatric department and started to receive prednisolone, vincristine and interferon alpha 2. During treatment, her general condition and platelet count recovered slowly, and the tufted angioma was also getting smaller and smoother. Kasabach Merritt syndrome is a complication of tufted angioma, which is characterized by platelet trapping in the vascular tumor. It can be induced by minor trauma such as punch biopsy or needle aspiration. We thought that this patient’s KMS was also induced by gun biopsy. The exact mechanism of inducing KMS is unknown, but the trauma is thought as angiogenesis stimulating factor. We report a case of tufted angioma with Kasabach Merritt syndrome following sono-guided gun biopsy. Based on this case, if the patient present suspicious tufted angioma or other unusual hemangioma lesion, we have to consider trauma can induce KMS and do biopsy if it has much more to gain than lose.