Bringing smiles back: A rare tumour on a child’s knee treated successfully

The six years old girl, had a reddish (vascular) papular lesion on the right knee, since birth which had started increasing in size in the past few months.

One day, on having a mild fall while playing, there was severe bleeding from the vascular lesion, which was controlled by compression for a few hours.
The patient was referred to the K J Somaiya Hospital, Super Specialty Centre for its expert care.

Dr Maunil Ajay Bhuta, Neuro & Vascular Interventional Radiologist at K J Somaiya Hospital, Super Specialty Centre, investigated further and it was found that she had a rare vascular tumour of the knee known as “Eccrine Angiomatous Hamartoma with a Huge Dilated draining vein”. This condition is very rare with an incidence of about 1 in 1000000. In this condition, the tumour draws blood supply from the normal leg arteries and is associated with a large draining (outflow) vein.

The doctors then discussed the options with the parents and explained the procedure necessary. A joint stepwise management plan was decided for the patient which consisted of endovascular embolisation of the arterial feeders (inflow channels) and laser ablation of the dilated draining vein (outflow channel) as the 1st step of treatment to shrink and devascularise the tumour, followed by surgical excision as the 2nd step.

Subsequently, the procedure of embolisation with laser ablation of draining vein was done at KJ Somaiya Super Speciality Hospital in the Cath Lab. The patient was discharged on the next day and was told to follow up after a week. On the follow-up, the tumour has significantly reduced in size and redness had also reduced significantly. The regression of the tumour was so good on the 8th post procedure day that the decision was made to withhold the 2nd surgical management step to observe whether the tumour regresses further on its own, which may eliminate the need for surgery completely.
And that, the little girl’s father, is what makes K J Somaiya Hospital, Super Speciality Centre so special “They lived up to the values they uphold and kept the welfare of the girl at every point of the treatment. They always tried to find solutions that would make the child suffer less. We now know that hospitals can truly be technically super and also empathetic.”