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LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies.
J Pediatr. 2010 Nov; 157(5):795-801.e1-7.JPed

Abstract

OBJECTIVE

To define the clinical spectrum of regional congenital anomalies associated with large cutaneous hemangiomas of the lower half of the body, clarify risk for underlying anomalies on the basis of hemangioma location, and provide imaging guidelines for evaluation.

STUDY DESIGN

We conducted a multi-institutional, retrospective case analysis of 24 new patients and review of 29 published cases.

RESULTS

Hemangiomas in our series tended to be "segmental" and often "minimal growth" in morphology. Such lesions were often extensive, covering the entire leg. Extensive limb hemangiomas also showed potential for extracutaneous anomalies, including underlying arterial anomalies, limb underdevelopment, and ulceration. The cutaneous hemangioma and underlying anomalies demonstrated regional correlation. Myelopathies were the most common category of associated anomalies.

CONCLUSIONS

We propose the acronym "LUMBAR" to describe the association of Lower body hemangioma and other cutaneous defects, Urogenital anomalies, Ulceration, Myelopathy, Bony deformities, Anorectal malformations, Arterial anomalies, and Renal anomalies. There are many similarities between LUMBAR and PHACE syndrome, which might be considered regional variations of the same. Although guidelines for imaging are suggested, prospective studies will lead to precise imaging recommendations and help determine true incidence, risk and long-term outcomes.

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Authors+Show Affiliations

Iacobas I
Department of Pediatric Hematology Oncology, Baylor College of Medicine, Houston, TX, USA.
Burrows PE
No affiliation info available
Frieden IJ
No affiliation info available
Liang MG
No affiliation info available
Mulliken JB
No affiliation info available
Mancini AJ
No affiliation info available
Kramer D
No affiliation info available
Paller AS
No affiliation info available
Silverman R
No affiliation info available
Wagner AM
No affiliation info available
Metry DW
No affiliation info available

MeSH

AlgorithmsCongenital AbnormalitiesFemaleHemangiomaHumansInfantInfant, NewbornMaleRetrospective StudiesSkin Neoplasms

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

20598318

Citation

Iacobas, Ionela, et al. "LUMBAR: Association Between Cutaneous Infantile Hemangiomas of the Lower Body and Regional Congenital Anomalies." The Journal of Pediatrics, vol. 157, no. 5, 2010, pp. 795-801.e1-7.
Iacobas I, Burrows PE, Frieden IJ, et al. LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies. J Pediatr. 2010;157(5):795-801.e1-7.
Iacobas, I., Burrows, P. E., Frieden, I. J., Liang, M. G., Mulliken, J. B., Mancini, A. J., Kramer, D., Paller, A. S., Silverman, R., Wagner, A. M., & Metry, D. W. (2010). LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies. The Journal of Pediatrics, 157(5), 795-e1-7. https://doi.org/10.1016/j.jpeds.2010.05.027
Iacobas I, et al. LUMBAR: Association Between Cutaneous Infantile Hemangiomas of the Lower Body and Regional Congenital Anomalies. J Pediatr. 2010;157(5):795-801.e1-7. PubMed PMID: 20598318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies. AU - Iacobas,Ionela, AU - Burrows,Patricia E, AU - Frieden,Ilona J, AU - Liang,Marilyn G, AU - Mulliken,John B, AU - Mancini,Anthony J, AU - Kramer,Daniela, AU - Paller,Amy S, AU - Silverman,Robert, AU - Wagner,Annette M, AU - Metry,Denise W, Y1 - 2010/07/02/ PY - 2009/11/10/received PY - 2010/03/10/revised PY - 2010/05/18/accepted PY - 2010/7/6/entrez PY - 2010/7/6/pubmed PY - 2010/11/3/medline SP - 795-801.e1-7 JF - The Journal of pediatrics JO - J Pediatr VL - 157 IS - 5 N2 - OBJECTIVE: To define the clinical spectrum of regional congenital anomalies associated with large cutaneous hemangiomas of the lower half of the body, clarify risk for underlying anomalies on the basis of hemangioma location, and provide imaging guidelines for evaluation. STUDY DESIGN: We conducted a multi-institutional, retrospective case analysis of 24 new patients and review of 29 published cases. RESULTS: Hemangiomas in our series tended to be "segmental" and often "minimal growth" in morphology. Such lesions were often extensive, covering the entire leg. Extensive limb hemangiomas also showed potential for extracutaneous anomalies, including underlying arterial anomalies, limb underdevelopment, and ulceration. The cutaneous hemangioma and underlying anomalies demonstrated regional correlation. Myelopathies were the most common category of associated anomalies. CONCLUSIONS: We propose the acronym "LUMBAR" to describe the association of Lower body hemangioma and other cutaneous defects, Urogenital anomalies, Ulceration, Myelopathy, Bony deformities, Anorectal malformations, Arterial anomalies, and Renal anomalies. There are many similarities between LUMBAR and PHACE syndrome, which might be considered regional variations of the same. Although guidelines for imaging are suggested, prospective studies will lead to precise imaging recommendations and help determine true incidence, risk and long-term outcomes. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/20598318/LUMBAR:_association_between_cutaneous_infantile_hemangiomas_of_the_lower_body_and_regional_congenital_anomalies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(10)00433-6 DB - PRIME DP - Unbound Medicine ER -