βブロッカー内服が奏効した乳児血管腫の2例

Treatment with peroral β-blocker was effective in two infants of periocular hemangioma

要約　目的：乳児血管腫は日本人の小児の約1％に発症する良性腫瘍である。近年βブロッカー内服の有効性が報告され，筆者らも速やかに軽快した2例を経験したので報告する。

症例：症例1は生後2か月の女児。右顔面から眼窩にかけての血管腫。初診時は腫瘤により開瞼できなかったが，βブロッカー内服により軽快し，視力左右差なく発達した。症例2は生後3か月の女児。右眼球突出。βブロッカー内服により眼球突出は速やかに軽快した。

結論：乳児血管腫は自然消退する疾患であるが，視覚障害を含めた機能低下の可能性がある場合や整容上問題となる場合には治療が必要であり，βブロッカー内服は効果的な治療であると考えられた。

Abstract　Purpose：To report 2 cases of periocular infantile hemangioma that healed after treatment with peroral β-blocker.

Cases and Clinical Course：Both were females who were seen after 2 and 3 months after birth respectively. One case showed hemangioma involving the right half of the face reaching into the orbit. The right eyelids were closed when seen initially. She was treated by peroral propranol at the dosis of 0.5 mg/kg. The eyelid could be opened on day 3 of treatment. The treatment was continued for 18 months. She appeared normal at the age of 3 years. Both eyes showed corrected visual acuity of 0.8. The second case presented with progressive proptosis of the right eye since one month before. MRI showed a multilobular tumor in the right orbit. She received gradually increasing dosis of peroral propranolol starting with 0.5 mg/kg. Proptosis started to regress one week later. Treatment was discontinued one year later after vascular component of the tumor had turned into fat tissue by MRI.

Conclusion：While infantile hemangioma is known to improve spontaneously, the present cases show that systemic treatment with β-blocker may induce improvement or cure in the presence of cosmetic or visual problems.