To understand why this case matters, it helps to know how vascular tumors of infancy are classified. Hemangiomas are the most common vascular tumors of infancy, and clinicians broadly divide them into infantile hemangiomas, which typically appear after birth and grow during early infancy, and congenital hemangiomas, which are fully formed by the time a baby is born. Congenital hemangiomas are themselves split into three behavioral categories: rapidly involuting congenital hemangiomas, which regress quickly after birth; non-involuting congenital hemangiomas, which persist indefinitely; and partially involuting congenital hemangiomas, which shrink somewhat but never disappear entirely. This three-way classification, formalized in influential work by Mulliken and Enjolras, reflects the fact that these tumors behave in fundamentally different ways despite looking superficially similar under the microscope.

The genetic underpinnings of congenital hemangiomas have become clearer in the past decade. Researchers have identified somatic activating mutations in the GNAQ and GNA11 genes in these tumors — alterations that occur in the tumor tissue itself rather than being inherited, and that drive the abnormal proliferation of blood vessel cells. This molecular signature distinguishes congenital hemangiomas from infantile hemangiomas, which follow a different biological program altogether. One of the classic diagnostic markers separating the two is GLUT1, a glucose transporter protein that is abundantly expressed in infantile hemangiomas but characteristically absent in congenital ones. Immunohistochemical staining for GLUT1, first described as a diagnostic marker for juvenile hemangiomas in landmark work published in 2000, remains a cornerstone of daily practice in distinguishing cutaneous vascular anomalies.

Most congenital hemangiomas appear on the skin and soft tissues of the head and neck or around the joints of the extremities — the periarticular regions. A RICH on a scalp or a knee is unusual enough; a RICH inside the brain, in the suprasellar region, is a genuine medical rarity. The suprasellar region is one of the most crowded and consequential addresses in the human brain. It houses the pituitary gland, the optic chiasm, the hypothalamus, and the circle of Willis, the arterial ring that supplies blood to much of the cerebrum. Tumors in this location — whether congenital craniopharyngiomas, hypothalamic hamartomas, or other lesions — can threaten vision, hormone regulation, and core metabolic functions, and they often demand delicate neurosurgical intervention. The prospect of a vascular tumor growing there before birth is the kind of finding that sets off immediate alarm bells in any fetal imaging suite.

That is precisely what makes the new report so valuable. The lesion was first detected on prenatal ultrasound, the workhorse of fetal surveillance, and then further characterized with fetal MRI, which offers superior soft-tissue contrast and can help differentiate vascular lesions from other fetal brain tumors. Fetal brain tumors themselves are exceedingly rare, and imaging them well is a technical challenge; a dedicated review of fetal brain tumor imaging published in Pediatric Radiology in 2020 underscored how difficult it can be to pin down a precise prenatal diagnosis. In this case, the imaging features and clinical course pointed toward a RICH, and the diagnosis was confirmed by the tumor’s behavior after birth: serial postnatal ultrasound and MRI demonstrated rapid interval regression, the hallmark of the rapidly involuting subtype.

The natural history of RICH tumors is what gives this case its happy ending. These tumors are fully grown at birth — they do not exhibit the postnatal proliferation phase that defines infantile hemangiomas — and then they begin to shrink, often dramatically, during the first months of life. Many resolve completely, sometimes leaving behind only a subtle patch of atrophic skin or residual telangiectasias when they occur on the skin. The speed of involution can be striking, which is how the subtype earned its name. But the behavior of a RICH in the brain is far less well charted than its cutaneous counterpart, simply because so few intracranial cases have been reported. Prior reports have described RICH lesions of the skull and the hand, and one team documented prenatal diagnosis and postnatal follow-up of a RICH in this same journal more than a decade ago, but suprasellar examples remain vanishingly scarce.

The clinical stakes of such a diagnosis are considerable. Congenital hemangiomas are usually benign and self-limited, but they are not always harmless. Rare catastrophic cases have been described in which congenital hemangiomas caused severe coagulopathy — a consumption of clotting factors by the tumor’s high-flow vasculature — leading to fatal cardiac failure in newborns. High-flow vascular lesions in the brain carry additional risks, including hemorrhage and mass effect on critical structures. For families and clinicians facing a prenatal diagnosis of a suprasellar mass, the differential diagnosis includes lesions with far grimmer prognoses, and the temptation toward aggressive intervention can be strong. A documented case in which watchful waiting was rewarded by spontaneous, imaging-confirmed regression provides a crucial data point: not every prenatal brain mass is a surgical emergency, and accurate diagnosis can spare an infant invasive procedures.

That said, the report also implicitly acknowledges that not all congenital hemangiomas can be left alone. When these tumors cause serious complications, medical therapy has entered the picture in recent years. Sirolimus, an mTOR inhibitor better known as an immunosuppressant, has emerged as a treatment option for problematic vascular anomalies, and a 2026 report in Pediatric Blood & Cancer described the successful management of a refractory congenital hemangioma with sirolimus in a neonate. The decision matrix for a neonatal vascular tumor thus spans a spectrum from simple observation to pharmacotherapy to, in select cases, surgery — and the choice hinges on accurate subtype classification, which is exactly where detailed imaging documentation like that in this new case report earns its keep.

For the radiology community, the case adds a rare entry to the atlas of fetal and neonatal intracranial vascular tumors, complete with the kind of longitudinal imaging follow-up that textbooks crave. For the broader public, it is a reminder of how much the prenatal imaging revolution has changed medicine: a tumor invisible to any previous generation of doctors is now spotted on ultrasound before a baby takes its first breath, characterized by MRI in utero, and tracked noninvasively as it resolves. The researchers reported no competing interests, obtained written informed consent from the child’s parents, and noted that institutional review board approval was not required for this single case report under institutional policies. The authors — Noman Khan, Rafaela Minguetti, Alexandra J. Borst, Kimberly M. Hamilton, and Carolina V. Guimaraes — frame the contribution around the clinical course and imaging features of the lesion, offering colleagues worldwide a template for recognizing a diagnosis that most will encounter only once, if ever, in their careers.

Behind the technical narrative lies a genuinely moving human story: parents who learned before birth that their child had a mass in one of the most delicate regions of the brain, and who then watched, scan by scan, as that mass melted away on its own. Medicine’s growing ability to distinguish tumors that threaten from tumors that retreat — using imaging signatures, immunohistochemical markers like GLUT1, and now somatic genetics — is quietly transforming outcomes for infants like this one. In an era when the word tumor triggers instinctive dread, this suprasellar RICH stands as a counterexample: a lesion that arrived fully formed, announced itself on fetal MRI, and then, true to its name, vanished in a rush — leaving behind only images, data, and a rare lesson in the power of knowing when to do nothing at all.

Subject of Research: A rare case of rapidly involuting congenital hemangioma in the fetal suprasellar brain region documented by prenatal and postnatal imaging

Article Title: Rapidly involuting congenital hemangioma of the suprasellar region

Article References: Khan, N., Minguetti, R., Borst, A. J., Hamilton, K. M., & Guimaraes, C. V. (2026). Rapidly involuting congenital hemangioma of the suprasellar region. Pediatric Radiology. https://doi.org/10.1007/s00247-026-06780-2

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06780-2

Keywords: congenital hemangioma, RICH, suprasellar region, fetal MRI, prenatal diagnosis, pediatric radiology, vascular tumors, GLUT1, GNAQ mutation, infantile hemangioma, spontaneous regression, neonatal imaging

The article appears in a journal that occupies a specialized niche within medical publishing. Pediatric Radiology, published by Springer Nature, serves as an international forum for research on diagnostic imaging of children, spanning radiography, ultrasound, computed tomography, magnetic resonance imaging, and interventional techniques. Within its pages, the journal maintains a tradition of short scholarly pieces devoted to the origins and meanings of eponyms, the shorthand terms that link contemporary imaging findings to the physicians and scientists who first described them. The Hermes entry, published on 10 September 2026 under the digital object identifier 10.1007/s00247-026-06779-9, continues that tradition. Such pieces are deliberately concise, but their purpose is far from decorative: they preserve the historical memory of the specialty and give young radiologists a vocabulary that connects them to generations of predecessors.

Eponyms occupy a curious position in medicine. On one hand, they are efficient. A single word can evoke a complex anatomical relationship, a pathognomonic appearance, or a well-defined syndrome without a lengthy description. On the other hand, they have been criticized for obscuring mechanism, for honoring discoverers whose contributions were contested, and for resisting translation across languages and cultures. In recent years, some journals have moved to retire eponymous terms in favor of descriptive nomenclature, particularly in anatomy, where international terminology committees have systematically replaced personal names with precise structural labels. Pediatric imaging has partly followed this trend, yet certain eponyms persist because they capture something that plain description does not: an image so characteristic that naming it after a figure from myth or history makes it memorable to students who must absorb thousands of patterns during training.

The choice of Hermes as a name is itself instructive. In Greek mythology, Hermes served as the herald of the gods, the swift messenger who moved freely between the divine and mortal realms, and the patron of travelers, merchants, and boundaries. His iconography, the winged sandals, the herald’s staff, the traveler’s cap, has been borrowed repeatedly in science and commerce, from the astronomical crater on Mercury to the luxury fashion house. In radiology, borrowing the name of a messenger god for a vascular or structural sign suggests motion, connection, and passage, qualities that resonate with the physiology of the newborn circulation. The fetal and neonatal circulatory systems are defined by shunts and channels that must close, redirect, or persist in tightly choreographed sequences, and imaging findings that reflect those transitions often lend themselves to vivid, metaphorical names.

Understanding why such a sign matters requires an appreciation of the umbilical circulation. Before birth, the umbilical arteries carry deoxygenated blood from the fetus to the placenta, while the umbilical vein returns oxygenated, nutrient-rich blood to the fetus. These vessels traverse the abdominal wall at the umbilicus and continue within the body along defined paths: the umbilical veins drain toward the portal system, and the umbilical arteries course along the lateral aspects of the bladder into the pelvis. At delivery, the cord is clamped and cut, the vessels thrombose, and over the following weeks the remnants transform into ligaments, the ligamentum teres within the falciform ligament of the liver and the paired medial umbilical ligaments beneath the peritoneum. In the immediate neonatal period, however, these vessels remain patent and visible, and on ultrasound or other modalities they can produce appearances that are normal, variant, or, in certain circumstances, indicative of pathology.

It is precisely in this window that eponymous signs earn their keep. A radiologist evaluating a newborn with abdominal symptoms must distinguish between findings that reflect the expected physiology of a recently delivered infant and findings that signal congenital anomalies, such as patent urachus, umbilical hernia, omphalocele, or vascular malformations. The umbilical region is anatomically crowded, containing the vestiges of fetal circulation, the urachal remnant that once connected the bladder to the allantois, and the entry point of the abdominal wall itself. Cross-sectional imaging of this region in neonates yields patterns that are unlike anything seen in adults, and naming conventions help the community accumulate, transmit, and verify collective experience about which patterns are benign and which demand intervention.

The Hermes entry also illustrates the pedagogical function of the eponym series. Radiology training relies heavily on pattern recognition, and pattern recognition is strengthened by narrative. When a sign is attached to a story, whether the story concerns the physician who first described it or the mythological figure whose attributes the finding evokes, learners retain it more effectively. Educational research in medical imaging has repeatedly shown that memorable associations improve diagnostic accuracy among trainees, and short-format articles that unpack the history and imagery behind a term serve exactly this function. For a journal aimed at pediatric imagers, whose readership includes fellows, residents, and sonographers who interpret neonatal studies daily, such entries function as compact teaching capsules that can be read in minutes and remembered for years.

There is also a broader lesson in how the specialty manages its vocabulary. The coexistence of eponyms and descriptive terms creates a dual system: formal nomenclature for communication with other specialties and for indexing in databases, and eponymous shorthand for rapid exchange among imaging specialists. Guidelines from professional bodies in radiology increasingly encourage descriptive language in reports to reduce ambiguity, yet the eponyms survive in teaching files, review courses, and board examinations. The result is a living lexicon in which some terms fade as their historical context is forgotten, while others, like those tied to unmistakable visual patterns, remain in active use. Tracking which terms endure and which disappear offers a small but genuine window into how medical knowledge evolves and how communities of practice decide what is worth remembering.

For readers of the journal, the value of the Hermes piece lies in its precision and its restraint. It does not overclaim; it situates a single term within the imaging of children and explains what the sign denotes and why the name was chosen. In an era when scientific publishing is dominated by large studies, meta-analyses, and artificial intelligence models, such a contribution may seem modest. Yet the infrastructure of reliable diagnosis depends on exactly this kind of shared, verified detail: the agreed meaning of a term, the correct anatomical correlate, and the confidence that when one radiologist writes a word, another will picture the same finding. Short scholarly notes that maintain that shared understanding perform a quiet but essential service for patient care.

The article, published open to subscribers of the journal and indexed under the journal’s standard citation format, joins a lineage of eponym entries that have appeared in Pediatric Radiology over the years, each taking a single term and restoring the context that daily use tends to strip away. For clinicians outside the specialty, the piece is a reminder that the words in an imaging report are not arbitrary. Behind each eponym stands a history of observation, debate, and refinement, and behind each mythological name stands a metaphor chosen to make a subtle finding unforgettable. In pediatric imaging, where the patients are the smallest and the findings often the most time-sensitive, that combination of precision and memorability is not a literary flourish. It is a working tool, and Hermes, the messenger whose name evokes speed and safe passage, turns out to be a fitting patron for a sign whose recognition can help guide the care of newborns.

Subject of Research: The Hermes eponym and umbilical vascular imaging signs in pediatric radiology

Article Title: Hermes

Article References: Hermes. (2026). Pediatric Radiology, 56(10), 2338-2339. https://doi.org/10.1007/s00247-026-06779-9

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06779-9

Keywords: pediatric radiology, Hermes sign, eponyms, neonatal imaging, umbilical vessels, medical nomenclature, pattern recognition, Springer Nature, diagnostic imaging, radiology education, newborn care, medical history