Lumbosacral hemangiomas raise risk for spinal anomalies

In a multicenter study, investigators prospectively examined 48 patients with infantile hemangiomas in the midline lumbosacral region that were at least 2.5 cm in diameter, finding that more than half the infants (51.2%) who underwent magnetic resonance imaging (MRI) had spinal anomalies. Most of these infants (mean age, 34.1 weeks) had no neurologic signs or symptoms of these anomalies, which were most often congenital lipomatous malformations of the spinal cord, generally with a dural defect. The presence of 2 or more lumbosacral cutaneous markers increased the risk of anomalies, although 35% of infants with isolated lumbosacral infantile hemangiomas had spinal anomalies. Larger hemangioma size and ulceration also raised the risk of spinal anomalies, but the association was statistically significant only for ulceration (P=.05).

Investigators also found that spinal ultrasound scanning, even when performed before the child is 4 months old, is not a sufficiently sensitive screening tool in this high-risk population; 42% of children with normal ultrasound results who then underwent MRI had spinal anomalies (Drolet BA, et al. J Pediatr. 2010;157[5]:789-794).

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