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Best of 2011

New Treatment for Hemangiomas

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Dr. Jonathan Perkins’ use of a blood pressure medicine to treat hemangiomas has reduced the need for surgery by 75%. Now he’s studying why the drug works.  

 
Hemangiomas are the most common type of tumor among infants. These abnormal lumps of blood vessels typically occur on the face or neck in one out of every 10 Caucasian infants, though 

We're taking the known outcomes from the bedside and going back to the bench.  We want to give families the most accurate information about which treatments are most likely to work." ~Dr. Jonathan Perkinsless frequently in infants of other races. Most hemangiomas disappear on their own by the time a child is 8 or 9, but some interfere with a child’s vital functions and must be treated early. The traditional course of treatment may last four years and include five or more laser procedures and surgeries — all requiring general anesthesia. In 2008, Dr. Jonathan Perkins heard a presentation describing how propranolol, a blood pressure medication, had shrunk the hemangioma of a patient in France quite by accident.

At the time, one of his own patients — a toddler with a hemangioma growing inside her throat that was so large she had to have tubes placed in her trachea and stomach so she could breathe and eat — was not responding well to conventional treatment. Given the severity of the child’s case, Perkins and her family decided that she should be the first in the region to try the drug.  

Within four months, the child’s tumor was completely gone.  

Today, Perkins, an otolaryngologist at Seattle Children’s, estimates that he performs 75% fewer surgeries to remove hemangiomas because the blood pressure medication is so effective in shrinking many (though not all) of the blood vessel tumors.

Finding answers through research    

Very few specialists in the country investigate why newborns develop hemangiomas in the first few weeks of life, but Perkins has been studying these and other vascular anomalies for more than 15 years. He is one of only a few researchers publishing on the topic.     

Perkins recently teamed with Dr. Mark Majesky, an expert in the cellular mechanisms of disease at Seattle Children’s Center for Tissue and Cell Sciences, to learn how propranolol works and why it helps some patients and not others.  

“There’s a desperate need for treatments beyond surgery that will work consistently,” explains Perkins. “We try to avoid surgery in infants whenever we can because the surgery can actually cause the hemangioma to become more inflamed.”

Using tissue samples that Perkins collected, the pair are comparing patients who have responded successfully to propranolol and those who have not.  

“We’re taking the known outcomes from the bedside and going back to the bench with the intention to develop new and better treatments for hemangiomas,” says Perkins. “We want to be able to give families the most accurate information possible about which treatments are most likely to work for their child.”  

Given the severity of the child's case, Dr. Jonathan Perkins and her family decided that she should be the first in the region to try propanolol.  Within four months, the child's tumor was completely gone.