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Khirurgii

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Year 2019 Vol. 27 No 1

REVIEWS

E.M. SHARAFANOVICH 1, 2, N.E. KONOPLYA 1, V.I. AVERIN 3

CONTEMPORARY OPTIONS FOR MEDICAL TREATMENT OF PEDIATRIC VASCULAR LESIONS

Belarusian Medical Academy of Post-Graduate Education 1,
Republican Scientific and Practical Center for Pediatric Surgery 2,
Belarusian Medical State University 3, Minsk
The Republic of Belarus

Vascular lesions constitute a considerable part (about 25%) of pediatric benign tumors and tumor-like masses. According to up-to-date understanding of vascular lesions (anomalies) they are divided into two main groups: vascular tumors (characterized by growth through cell proliferation) and vascular malformations (structural abnormalities of vessels development).
The mechanism of action of drugs for vascular lesions systemic medication aims at proliferation and angiogenesis, therefore that kind of management has implement mostly to vascular tumors.
The most significant pediatric benign vascular tumor is infantile hemangioma (IH). The distinctive features of IH, as a separate nosology, are its typical clinical course with phases of proliferation and subsequent involution, GLUT1 expression at immune-histochemical staining, and also positive response to beta-blockers treatment, in particular, to non-selective beta-blocker propranolol that, at present, has got a main place in the management of this kind of vascular tumors.
In certain vascular malformations molecular-genetic researches of recent years have demonstrated alterations relating to cell cycle regulation and vasculature development. For clinical course improvement of some vascular malformations, a medical treatment can be also applied.
The article presents an up-to-date vascular lesions classification and terminology, describes options of medical management for vascular tumors and tumor-like masses, provides some of their pathogenetic aspects that determine the prospects of new pharmaco-therapeutic approaches to vascular anomalies management.

Keywords: hemangioma, vascular malformations, vascular neoplasms, infantile hemangioma, propranolol, beta blockers, targeted treatment
p. 81-90 of the original issue
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Address for correspondence:
220013, The Republic of Belarus,
Minsk, P. Brovko Str., 3-3,
Belarusian Medical Academy
Of Post-Graduate Education,
Department of Pediatric Oncology and Hematology.
Tel. mob.: +375 29 684-34-04,
e-mail: sharafanovich1@gmail.com,
Elena M. Sharafanovich
Information about the authors:
Sharafanovich Elena M., Applicant of the Department of Pediatric Oncology and Hematology, Belarusian Medical Academy of Post-Graduate Education, Pediatric Surgeon of the Surgical Unit №2, Republican Scientific and Practical Center for Pediatric Surgery, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-4238-9926
Konoplya Natalya E., MD, Associate Professor, Professor of the Department of Pediatric Oncology and Hematology, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-0592-7182
Averin Vasily I., MD, Professor, Head of the Department of Pediatric Surgery, Belarusian Medical State University, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-3343-8810
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