Managing hemangiomas

To the Editor.— We read with interest the article, "Management of Alarming Hemangiomas in Infancy: A Review of 25 Cases" by Enjolras et al, in the April, 1990 issue of Pediatrics. We note that all three patients with liver hemangiomas died. We would like to draw your attention to two articles that we have published with regard to treatment of life-threatening hemangiomas with cyclophosphamide.1,2 In our series of four patients, the very large intrahepatic tumor resistant to prednisone in one infant who also had congestive heart failure completely resolved with two courses of cyclophosphamide.