Infantile hemangioma
D. Oral sirolimus
This is a complex hemangioma spanning multiple compartments of the left midface that has persisted despite propranolol, oral prednisolone, and multiple debulking surgeries. Sirolimus, an mTOR inhibitor that has antiangiogenic effects via regulation of cellular growth and proliferation pathways, is a viable treatment option for infantile hemangioma that has increasingly been used to treat refractory hemangiomas with success.1- 6
Infantile hemangioma is a benign vascular tumor occurring in 5% of infants worldwide.7 These endothelial cells are characterized by rapid proliferation in the first 3 months of life followed by slow involution.7 Infantile hemangiomas are differentiated from other vascular tumors by their clinical course and glucose transporter 1 positivity.8 While many infantile hemangiomas require only observation, medical treatment is recommended for eyelid or orbit hemangiomas that cause visually significant ptosis, strabismus, astigmatism, and amblyopia.7