Hemangiomas, also known as hemangiomas of infancy or infantile hemangiomas (IH), are the most common benign tumor of infancy[1]. They are often called "strawberry marks" due to their clinical appearance.
These conditions can be life-threatening if they're large or affect your child's airway or another organ. A hemangioma can also be serious if it has uncontrollable bleeding. Depending on where your child's growth is located, it may cause physical problems.
The direct cause is unknown. In children, hemangiomas are caused by blood vessels that don't develop correctly during pregnancy. Though some hemangiomas develop in adults after an injury or illness, researchers haven't established what causes hemangiomas.
Because hemangiomas very rarely become cancerous, most do not require any medical treatment. However, some hemangiomas can be disfiguring, and many people seek a doctor's care for cosmetic reasons.
All birthmarks, including hemangiomas, should be evaluated by your provider during a regular exam. Hemangiomas of the eyelid that may cause problems with vision must be treated soon after birth. Hemangiomas that interfere with eating or breathing also need to be treated early.
Most strawberry hemangiomas are harmless. But some hemangiomas do cause problems if they: Form near the eye: These hemangiomas may spread into the eye socket and press on the eye, affecting vision. They raise the risk of problems like glaucoma or lazy eye (amblyopia).
Hemangioma is a noncancerous tumor, which means it cannot become cancerous. It is a bright reddish-blue enlargement of the blood vessel.
Most infantile hemangiomas do not need to be treated with surgery. Surgery is less common now than in years past because of the medicines available now that are safe and effective. Hemangiomas that have noticeable scar tissue left after shrinking may need surgery.
The prognosis is very good for uncomplicated IH and there is complete involution in the majority of cases. 50% of hemangiomas will resolve in 5 years, 70% by 7 years and 90% by 9 years.
Percutaneous biopsy of a hepatic hemangioma carries an increased risk of hemorrhage. Liver biopsy is contraindicated in most circumstances where a hemangioma is high in the differential diagnosis of a hepatic mass. Liver biopsy can help provide an unequivocal histologic diagnosis and may shorten the diagnostic workup.
The cause for hemangiomas and vascular malformations is usually sporadic (occurs by chance). However, they can also be inherited in a family as an autosomal dominant trait.
We treat both hemangiomas and vascular malformations as part of a larger, multidisciplinary team comprised of plastic surgeons, interventional radiologists and dermatologists with a strong interest in evaluating and treating these disorders.
Complications. Occasionally, a hemangioma can break down and develop a sore. This can lead to pain, bleeding, scarring or infection. Depending on where the hemangioma is situated, it may interfere with your child's vision, breathing, hearing or elimination, but this is rare.
Types of Hemangiomas
Superficial (on the surface of the skin): These look flat at first, and then become bright red with a raised, uneven surface. Deep (under the skin): These appear as a bluish-purple swelling with a smooth surface.
High-risk infantile hemangiomas are characterized by location, size, and number. Hemangiomas near the eye may affect vision, and lesions near the eye, ear, and nose have high risk of disfigurement.
Rarely, vertebral hemangiomas will cause compressive neurological symptoms, such as radiculopathy, myelopathy and paralysis. In these cases the clinical presentation is usually the subacute or delayed onset of progressive neurological symptoms.
Infantile hemangiomas typically go through three characteristic phases: proliferation, plateau, and involution.
About 80 percent of hemangiomas stop growing by about 5 months, Dr. Antaya says. After hitting this plateau phase, they stay unchanged for several months, and then begin to slowly disappear over time (called involution). By the time children reach 10 years of age, hemangiomas are usually gone.
What Is a Hemangioma? Spinal hemangiomas are benign tumors that are most commonly seen in the mid-back (thoracic) and lower back (lumbar). Hemangiomas most often appear in adults between the ages of 30 and 50. They are very common and occur in approximately 10 percent of the world's population.
Laser surgery is beneficial in treating both proliferating and residual vessels from hemangiomas. The flashlamp-pumped pulsed-dye laser has become the most widely used laser for selective ablation of vascular tissue in childhood.
Surgery is an option for removing a haemangioma but this depends on its size and location. Generally, surgery is suggested for 'functional' reasons, for instance, if a haemangioma is interfering with breathing or feeding. The surgeon will remove the haemangioma tissue and join the healthy skin together.
In small, superficial hemangiomas, a gel containing the drug timolol may be applied to the affected skin. A severe infantile hemangioma may disappear if treated with an oral solution of propranolol. Treatment usually needs to be continued until about 1 year of age.
Bleeding occurs when the skin overlying the hemangioma breaks down. In most cases, such bleeding is not life-threatening and will stop with application of firm pressure over the area for 5 to 15 minutes. However, when bleeding cannot be controlled with hand pressure, the child should be seen by a physician immediately.
Hemangioma in the fatty liver
Hemangioma may appear hypoechoic on ultrasonography if it occurs in fatty liver. In this case, the diagnosis of hemangioma can be made by contrast-enhanced CT if the lesion is large enough or MR imaging if the lesion is small.
Some hemangiomas grow back after removal, unlike other benign growths, which do not return after surgery. Large liver hemangiomas in infants can lead to heart issues due to their effect on blood vessels.