Scarlet Enigma: A Case of Diffuse Neonatal Hemangiomatosis

Infantile hemangioma is the most common vascular tumor in the neonatal stage, characterized by the proliferation of endothelial cells and generally exhibiting benign behavior. However, the presence of more than five skin lesions may indicate involvement of other organs, particularly the liver, where the prognosis can worsen due to associated cardiac, thyroid, and hematological complications. This study involves a case analysis and a review of current literature. The clinical case discusses a 39-day-old female infant with a history of NICU management, presenting with multiple generalized cutaneous hemangiomas from birth and an episode of gastrointestinal bleeding. Imaging revealed numerous hepatic hemangiomas and significant hepatomegaly, while laboratory tests showed coagulation abnormalities and thrombocytopenia. A diagnosis of diffuse neonatal hemangiomatosis (cutaneous and hepatic) was made, and treatment with propranolol was initiated. The prognosis for diffuse hemangiomatosis is severe due to the high risk of hemorrhagic complications if treatment is not promptly started. Therefore, we recommend initiating propranolol treatment upon evidence of such lesions, even before beginning the diagnostic protocol.