Intra-abdominal multi-organ involvement of kaposiform hemangioendothelioma in a child with Kasaback-Merritt phenomenon and contrast-enhanced ultrasound findings: A case report

Shu LuoAnjie ChenJiaojiao ZhouYi JiShuguang JinJuxian Liu^*

• West China Hospital of Sichuan University, Chengdu, China

Kaposiform hemangioendothelioma (KHE) is a rare, endotheliogenic and locally aggressive vascular tumor that typically occurs during infancy or early childhood. KHE usually has a cutaneous origin, affecting the extremities, cervicofacial and torso body wall; a few abdominal organs are also involved. The abnormal proliferation of capillaries and lymphatic capillaries can activate platelets in the blood, leading to Kasabach-Merritt phenomenon (KMP), which is characterized by intractable thrombocytopenia, hypofibrinogenemia, coagulation dysfunction and severe anemia[1,2]. KHE imaging usually includes magnetic resonance imaging (MRI), computed tomography (CT), gray-scale ultrasound, doppler ultrasound and ultrasonic elasticity. However, the use of contrast-enhanced ultrasound (CEUS) has not been reported to date, at least to the best of our knowledge. The present study described that a child had a rare case of KHE in pancreatic head invading multiple abdominal organs with KMP and multiple secondary lesions with a hidden and complex diagnosis. The use of CEUS, for the first time, revealed KHE lesions in the pancreatic head with the malignant tumor enhancement mode. In the treatment, the recovered patient was treated with variable of medical therapies, followed by the surgical resection of the lesions.