Side-effect proves blessing for birthmark

26/11/2008

A tiny red mark on Finn Boucher's top lip - spotted by his mother soon after his birth just 10 weeks ago - quickly became a big problem.

The strawberry mark, a tumour of small blood vessels, grew rapidly, making feeding difficult and blocking one nostril.

His parents, Sue and Regan Boucher, of Invercargill, were so worried they took him to Southland Hospital's emergency department five weeks ago.

"Feeding was the biggest issue, but he's our first and I don't think we realised quite how painful it was for him," Mrs Boucher said. "When the staff at the hospital saw him, I think they were quite shocked at how big it had got."

Finn spent five days in hospital being fed through a nasal tube. He was prescribed high-dose steroids, but the tumour kept growing, and doctors were considering chemotherapy, which has even more serious side-effects.

Finn was referred to Hutt Hospital's vascular birthmark centre.

Fortunately for him, director of surgery Swee Tan had recently attended an international conference on vascular birthmarks in Boston and heard about a breakthrough in France.

Doctors treating children for high blood pressure - common in people with strawberry marks because of the steroids and the pressure on the heart from pumping so much blood to the tumour - found one drug had a very positive side-effect.

"Quite serendipitously, this drug, propranolol, made the tumour shrink quite dramatically," Dr Tan said.

He and Hutt paediatrician Philip Leadbitter thought Finn would be an ideal candidate. "The other great thing about this drug is we know it is quite safe for babies, whereas steroids can stunt children's growth and cause other problems and are only effective in a third of cases."

Finn began treatment eight days ago and already the birthmark is in retreat.

Dr Tan said doctors did not yet know how the drug stopped cells dividing.

"We're now going to look at it in the lab to work out what molecular pathway is involved so we can target that."

Finn went home on Tuesday and will probably be kept on the drug for about six months. It is expected the tumour will disappear within a year.

While his tumour is shrinking, Finn has already outgrown most of his clothes in the past week.

"His father was worried he was going to become a midget because of the steroids, but it doesn't look like that will be a problem," Mrs Boucher said.