Case Report: Fetal giant congenital hemangioma with arteriovenous malformation: to be or not to be

Abstract

Objective This study reports a rare and life-threatening case of a giant congenital hemangioma with arteriovenous fistula in a neonate and describes its clinical management and outcomes. Method A female neonate with a giant right forearm hemangioma with arteriovenous fistula, detected prenatally at 23 weeks, was managed by a multidisciplinary team. Postnatally, the infant developed severe pulmonary hypertension and active bleeding from the mass. Diagnosis was confirmed via computed tomography angiography and arteriography. Emergency intervention with combined embolization coil and sclerotherapy was performed, followed by oral propranolol therapy. Results Following the combined intervention and pharmacotherapy, the condition of the infant improved significantly. The severe pulmonary hypertension resolved, and the tumor size progressively reduced. Conclusion Congenital hemangioma combined with arteriovenous malformation can lead to severe, life-threatening complications. A prompt, multidisciplinary approach involving embolization, sclerotherapy, and pharmacotherapy can achieve favorable outcomes, underscoring the importance of early recognition and integrated perinatal management.