Soft-Tissue Congenital Hemangiomas and Related Complications: A Retrospective Cohort of 14 Cases With Emphasis on Prenatal Diagnosis, Counseling, and Postnatal Management

Objectives: We aimed to describe prenatal imaging findings of superficial congenital hemangiomas (CH), review associated complications, and describe outcomes. Methods: A single-center retrospective cohort study spanning 18 years (2006–2024) reviewed imaging and medical charts of fetuses with soft-tissue masses suggestive of CH on prenatal ultrasound and/or magnetic resonance imaging, confirmed postnatally through evolution or histopathology. Results: All 14 cases (7 [50%] head and neck, 5 [36%] extremities, and 2 [14%] trunk) showed hypoechoic hypervascular masses on Doppler ultrasound with internal vascular ectasias, 12 (86%) being well circumscribed, and 5 (36%) having intralesional echogenic foci. Seven (50%) had a large draining vein and 5 (36%) showed right atrial enlargement. Magnetic resonance imaging (n = 11) demonstrated a well-circumscribed lesion in 9 (82%) cases, hypointense in 4 (36%), and iso- to hyperintense in 7 (64%) on T2-weighted imaging. Seven (64%) cases had internal T2-hypointense areas; none showed cystic areas or muscle invasion. One pregnancy was terminated. Of the 13 live births, all lesions showed complete or partial involution within a year; 3 (25%) developed superficial ulceration and 1 (8%) transient symptomatic heart failure. Four patients underwent elective surgery. Conclusion: Fetuses with CH had favorable outcomes, highlighting the importance of accurate prenatal diagnosis and delivery in specialized centers to manage potential complications.