Transarterial Embolization of a Cervicofacial Hemangioma Associated with Kasabach-Merritt Syndrome in a Premature Neonate

Abstract

Here we describe successful transarterial embolization in a prematurely delivered neonate with Kasabach?Merritt syndrome (KMS) associated with cervicofacial hemangioma and a large intracranial hematoma. A male infant was delivered by cesarean section at 33 weeks of gestation because of an intracranial hematoma noted on fetal ultrasonography (US). His birth weight was 2.17 kg, and 5-minute Apgar score was 5. He had a reddish-colored mass covering the whole of the right side of his face and neck (Fig 1). Initial laboratory tests revealed thrombocytopenia (< 10 × 103/mm3; normal range, 150?450 × 103/mm3), prolonged prothrombin time (13.8 s; normal range, 9.0?13.2 s), prolonged activated partial thromboplastin time (85 s; normal range, 25?39 s), increased International Normalized Ratio (1.29; normal range, 0.82?1.2), increased fibrin degradation products (> 20 μg/mL; normal range, 0?5 μg/mL), decreased fibrinogen (161 mg/dL; normal range, 190?430 mg/dL), and increased D-dimer (3.44 mg/L; normal range, 0?0.24 mg/L). Increased vascularity of the mass was evident on US.