Hemangiomas & Other Vascular Tumors

Hemangiomas

Infantile hemangiomas are a collection of blood vessels that create a bright red or blue-purple appearance on or under the skin. They are called a vascular tumor because they do grow although they are benign. At birth, the hemangioma is not visible, but becomes apparent shortly after birth. Some hemangiomas are present at birth and are called congenital hemangiomas.

• Hemangiomas are the most common benign vascular tumor in infancy
• Incidence of occurrence is up to 10% by one year of age
• More common in females than males
• More common in premature babies
• A serious problem is when a hemangioma occurs in the airway and causes breathing problems
• In some instances, children with large hemangiomas or many hemangiomas may need to be evaluated for associated medical problems.
• Treatment options may include the use of medications, laser treatments, surgery or ongoing observation by a pediatric specialist

Other vascular tumors

The abnormal growth of blood vessels are called vascular tumors. They may look like a birthmark or infantile hemangioma. Examples of other vascular tumors include kaposiform hemangioendothelioma and tufted angioma.

Venous Malformations

• Incidence of occurrence is 1-4 % meaning that 1-4 children of every 100 children born may have a venous malformation
• Generally a venous malformation is present at birth although it may not be noticed immediately
• Usually grow as the child grows
• They are benign, bluish in color, non-pulsatile and soft
• They can bulge when the child is straining, standing, crying or there is increased heat (hot bath)
• Treatment options include:
  • Observation by a pediatric specialist
  • Medications that help control size and symptoms
  • Injections that shrink the size of the vessels which is called sclerotherapy
  • Surgical excision

Lymphatic Malformations

Lymphatic malformations are usually present at birth but may not be recognized until they become larger and symptomatic. 90% are generally recognized by two years of age. They may be mixed with venous malformations and can look similar to a venous malformation.

• Incidence of occurrence is 1-2.8% meaning that 1-2.8 children of every 100 children born may have a lymphatic malformation
• Can be mixed with venous malformations
• Usually grow as the child grows
• They are benign and are soft to the touch
• They may fluctuate in size with an increase in growth during infections/colds
• Multiple treatment options including:
  • Observation by a pediatric specialist
  • Medical management
  • Surgery
  • Sclerotherapy (injecting the malformation with medication that shrinks the malformation)

Capillary Malformations

• Present at birth, but may darken in color with thickening of the skin as the child ages
• Appear red/purple in color and have discrete borders
• If located in specific areas to the face, further assessment is recommended to rule out Sturge Weber Syndrome
• Treatment options vary according to the location. Laser treatment is most commonly used

Arteriovenous Malformations (AVM)

• Composed of malformed arteries and veins
• These malformations have a pulsation when touched
• Different in size, but some can swell, ulcerate and cause active bleeding
• Found within internal organs as well, with the most frequently occurring location is in the brain
• Present at birth
• Grow with the child
• Generally benign, but serious forms can be life threatening
• Treatment options can be challenging and can include the following:
  • Surgical excision
  • Injection of material that plugs and stops the blood flow through the malformation (embolization)