Screening for infantile hepatic hemangioma in patients with cutaneous infantile hemangioma: A multicenter prospective study.

Background: Abdominal ultrasonography has been proposed to screen for infantile hepatic hemangioma (IHH) in patients with multiple cutaneous infantile hemangiomas (IHs).

Objectives: The aim of this study was to establish the optimal cutoff point for the number of cutaneous IHs needed to screen for IHH.

Methods: We performed a prospective, multicenter study to screen for IHH in patients younger than 9 months who had multiple cutaneous IHs (n ≥ 3) on ultrasonography. For comparison, a group of patients with 1 or 2 focal cutaneous IHs was also recruited.

Results: In total, 676 patients with at least 3 cutaneous IHs and 980 patients with 1 or 2 focal cutaneous IHs were enrolled. Thirty-one patients were found to have IHH. A higher number of cutaneous IHs was associated with an increased risk of IHH (R = 0.973; P < .001). Receiver operating characteristic curve analysis showed that 5 cutaneous IHs was the optimal cutoff point to screen for IHH, with an area under the curve of 0.872 (P < .001; 95% confidence interval, 0.789-0.955).

Limitations: This was an uncontrolled study.

Conclusions: Screening for IHH is recommended in patients younger than 9 months who present with 5 or more cutaneous IHs.