Hemangioma
Alternative
names
Cavernous hemangioma; Strawberry
nevus
Definition
Hemangiomas are abnormally
dense collections of dilated small blood vessels
(capillaries) that may occur in the skin or internal
organs.
Causes
and risks
The classically recognized
hemangioma is a visible red skin lesion that may
be superficial in the skin (in the top layers,
called a capillary hemangioma), deeper in the
skin (cavernous hemangioma), or a mixture of both.
Hemangiomas are usually present at birth although
they may appear within a few months of birth often
beginning at a site that has appeared slightly
dusky or colored differently than the surrounding
tissue.
Hemangiomas, both deep and superficial, undergo
a rapid growth phase in which their volume and
size increase rapidly. This phase is followed
by a rest phase, in which the hemangioma changes
very little, and an involutional phase where the
hemangioma undergoes spontaneous regression. During
the involutional phase, hemangiomas may disappear
completely. Large cavernous hemangiomas distort
the skin around them and despite full involution,
will ultimately leave visible changes in the skin.
The more superficial capillary hemangioma may
involute completely, leaving no evidence of its
past presence.
Hemangiomas may be present anywhere on the body.
However, they are most disturbing to parents when
they are on the infant’s face or head. Hemangiomas
of the eyelid may interfere with the development
of normal vision and must be treated in the first
few months of life. On rare occasions, the size
and location of hemangiomas may interfere with
breathing, feeding, or other vital functions.
These lesions also require early treatment.
Large cavernous hemangiomas may develop secondary
infections and ulcerate. Bleeding is not uncommon
and may be significant following injury to the
hemangioma.
Prevention
There is no known way to
prevent hemangiomas.
Symptoms
- red to reddish purple
raised vascular lesion on the skin
- possibly massive,
markedly elevated vascular tumor
Signs
and tests
Hemangiomas are diagnosed
by physical examination. In the case of deep or
mixed lesions a CT scan or MRI scan may be performed
to ensure that deeper structures are not involved.
On occasion, hemangioma may be associated with
other rare syndromes. Additional studies may be
done to determine if any of these syndromes are
present.
Treatment
Superficial or "strawberry
hemangiomas" often are not treated. Letting the
lesion undergo spontaneous involution produces
normal-appearing skin. In some cases, a laser
may be used to eradicate the small vessels. Cavernous
hemangiomas that involve the eyelid and obstruct
vision are generally treated with injections of
steroids or laser treatments that rapidly reduce
the size of the lesions, allowing the development
of normal vision.
Large cavernous hemangiomas or mixed hemangiomas,
when appropriate, are treated with oral steroids
and injections of steroids directly into the hemangioma.
Recently, lasers have been used to reduce the
bulk of the hemangiomas. Lasers emitting yellow
light can selectively damage the vessels in the
hemangioma without damaging the overlying skin.
Some physicians are using a combination of steroid
injection and laser therapy together.
Prognosis
Small superficial hemangiomas
should involute completely. Large cavernous hemangiomas
should be evaluated by a physician and treated
appropriately. |
