What is a hemangioma?
A hemangioma is a benign (non cancerous) tumor of the cells that line blood vessels. They typically appear in the first weeks of a child's life and can grow quickly. This is called the proliferative phase. Then they enter a phase of shrinking. This is called the involuting phase. Typically, the hemangioma grows very quickly but shrinks slowly. Hemangiomas typically reach their final size by five months of age, but it can take longer.
A more rare type of hemangioma is a congenital (from birth) hemangioma. The hemangiomas appear before a child is born. There are two types. Rapidly involuting hemangiomas fade rapidly within the first year of life. Noninvoluting hemangiomas never fade.
Hemangiomas are more common in caucasians, girls, premature infants, and twins.
What are symptoms of a hemangioma?
About half of hemangiomas appear on the head or neck but they also can appear on the trunk, arms, or legs. They usually are red, purple, or blue. The coloring can be very bright or can appear more faded. The texture and appearance of the hemangioma will change over time depending on where it is in its proliferative or involuting phase.
Sometimes hemangiomas aren't visible outside the body because they have grown in an internal organ, such as the liver or gastrointestinal tract. In these cases, there are usually two or more hemangiomas on the outside of the body as well.
Congenital hemangiomas may appear similar to a large bruise or sore. They are round or oval, grayish in color with areas of red, and may be circled with light-gray skin. Congenital hemangiomas typically fade quite rapidly within the first year.
How are hemangiomas diagnosed?
Hemangiomas are most frequently diagnosed by patient history and physical examination. When there is a deep lesion, magnetic resonance imaging (MRI) may be performed to determine the extent of the problem and if there is any involvement of internal organs. Rarely, hemangiomas are associated with unusual syndromes. A thorough examination and additional studies may be required to detect the presence of these syndromes.
How are hemangiomas treated?
Most hemangiomas fade on their own and leave behind almost-normal skin, although a primary care physician should monitor the hemangioma during this process. A vascular anomalies specialist should be contacted if:
there is more than one hemangioma (which sometimes signifies an internal, more serious hemangioma in need of immediate treatment.)
- the diagnosis is unclear.
- the hemangioma is large.
- it is growing rapidly.
- it is located in an area where it disfigures or blocks the nose, eyes, mouth, or airway.
- it is on the eyelid, which can affect vision.
The vascular anomalies team treats hemangiomas with medications, steroids, lasers (PDF), and/or surgical removal, depending on the unique characteristics of your child's hemangioma. The most rare treatment is surgical removal. Surgical removal usually is only necessary when a hemangioma interferes with breathing, vision, hearing, or eating.
A small number of children with a hemangioma develop an ulcer on the lip or in the peri-anal or genital region. These are treated with antibiotics, frequent cleansing, dressings, and sometimes surgical removal.
About treatment for hemangiomas at Children's
Hemangiomas are one of the most common conditions treated through Children's Vascular Anomalies Center, which is located on our Minneapolis campus. By coordinating experts from several pediatric disciplines into a single visit, families experience a new level of convenience in an environment focused exclusively on pediatrics. Every child is assigned a pediatric nurse case manager who coordinates all treatment and communication between care providers and the family.
For consultation, referral, or an appointment, call the Vascular Anomalies Center at 612-813-7100.