Infantile hemangioma of the genital region: A Case Report

Background: Infantile hemangiomas (IH) are the most common benign tumors in infancy, with a prevalence
of 4.5%; less than 1% of these tumors are located in the genital region. This is a case of a 6 weeks old infant
presenting with IH in the genital region.
Case presentation: Physical examination revealed a large genital cavernous hemangioma measuring 5 ×
4 cm, which involved the labia majora, labia minora, and clitoris. Additionally, several hemangiomas were
observed in the lower abdominal wall. A non-indurated ulcer measuring 1 × 1 cm with well-defined margins
and a base covered with granulation tissue was observed on the right labia majora of the patient.
Ultrasonography of the abdomen, brain, and heart and ECG were normal. We initiated therapy with
propranolol (1 mg/kg) in an inpatient setting, with 24h monitoring of possible side effects. The therapy was
well tolerated and no adverse effects were observed. After one week, the dose of propranolol was increased
to 2 mg/kg in an outpatient setting. After two weeks, there was a great response to the therapy; the
hemangioma started to decrease in volume, and the ulceration disappeared. At the age of 16 months, we
stopped propranolol therapy when the hemangioma had almost completely disappeared.
Conclusion: Genital IH is rare but is associated with a high risk of ulceration and possible functional
impairment. If therapy is indicated, propranolol is effective in the treat