Case of the Week #556

Frantisek Grochal (1); Haslik Lubomir (2)
(1) Femicare, Center of prenatal ultrasonographic diagnostics, Kollarova 17/A, 036 01 Martin, Slovak Republic; (2) The Institute for Mother and Child Care in Prague - Podolí, Czech Republic

Posting Dates: April 1 - April 14, 2022

Case Report: A 24-year-old secundigravida, primipara presented to our office at 24 weeks and 6 days of her pregnancy due to a right-sided cranial parieto-occipital mass of the fetus. We obtained the following images.

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Answer

We present a case of hemangioma-hemangioendothelioma.

Our ultrasound images at 24 weeks, 6 days show a highly vascularized, mostly solid mass measuring 58 x 45 x 34mm in the right-parieto-occipital subcutaneous region. Vascular supply of the lesion could be traced to the right vertebral artery. Repeat ultrasound exams done later in pregnancy demonstrated that the size of the mass remained stable with overall mass volume about 58 cm³.

The mother was sent to The Institute for Mother and Child Care in Prague - Podolí, Czech Republic, for consultation and further management. A eutrophic male newborn was delivered via cesarean section at 38 weeks and 3 days due to non-progressive labor.

Diagnosis of hemangioma-hemangioendothelioma was clinically confirmed after delivery. The baby was placed on Propranolol treatment. At the time of posting this case, the baby is four months old and is doing well. The size of the tumorous mass diminishes gradually, and so no surgical treatment has been recommended thus far.