Hemangiomas are benign vascular tumors that commonly affect infants and children, primarily appearing on the face. The good news is that many hemangiomas naturally regress over time, with no threat to life expectancy. For parents, the main concern is often the cosmetic aspect. They are non-cancerous so there is nothing to worry about the life expectancy of the children.
Hemangiomas are the most prevalent benign tumors in infants, with an incidence of 4% to 10% by the age of 1 year. Low birth weight and premature infants have a higher risk, up to 23%. These tumors typically don’t pose health issues but may rarely bleed or become painful.
Approximately 60% of hemangiomas occur on the head and neck, 25% on the trunk, and 15% on the extremities. Most hemangiomas present as a single tumor.
Diagnosis is usually made after a detailed history by the parents and physical examination of the child. Sometimes an Ultrasound, CT scan or MRI scan is done to see its extent and nature.
These tumors usually develop within the first few weeks of life but these usually resolve spontaneously by the age of 10 years. Depending on their size and location, they may be disfigured too.
Proper diagnosis by a trained plastic surgeon is a must.
Differentiation between other vascular tumors like Low flow vascular malformation and high-flow vascular malformation is a must before deciding on any treatment.
1. Medicines
2. Pulsed dye and Nd: YAG lasers can be used in the treatment of superficial hemangiomas, and a few ulcerated hemangiomas and for removing residual color from regressed hemangiomas. However, it is not a common modality of treatment.
3. Surgery: Hemangiomas within the body may require surgery only if they grow too large cause problems in vision or feeding or if it is bleeding. Surgery is typically delayed until the child is of school age and beginning to experience psychological consequences.
1. Surgery is preferably avoided in children with hemangiomas as they can cause more severe deformities or scars after surgery.
2. Surgery is usually reserved for hemangiomas in children or babies if the medical treatment has failed and the tumor threatens important structures or functions like-
3. Surgery is more commonly done for regressed hemangiomas during adolescent and teenage years after the tumor has resolved and left a residual scar or deformity over the region.
Surgery of choice is the Excision of residual tumor or scar left by the hemangioma. The skin coverage is by multiple scar revisions or skin grafting with or without flap cover. For bigger scars, tissue expansion can be done.
The post-operative recovery is rapid and would require 3-4 days of hospitalization.
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Hemangiomas are common vascular birthmarks characterized by a collection of blood vessels. In children, they typically appear as a raised, red or purplish lump on the skin.
The exact cause of Hemangiomas is not fully understood, but they are believed to result from abnormal growth of blood vessels. They often appear in the first few weeks of life.
Hemangiomas can be superficial (on the skin’s surface) or deep (within the tissues). They can also be classified as strawberry hemangiomas, which are red and raised, or cavernous hemangiomas, which are bluish and deeper in tissue.
Hemangiomas are typically benign and pose no immediate health threat. However, they can grow rapidly and may interfere with a child’s function or appearance, which may necessitate treatment.
Diagnosis is typically based on a clinical examination by a healthcare professional. Imaging studies like ultrasound or MRI may be used to assess the Hemangioma’s characteristics.
Treatment options may include medication, laser therapy, or surgical removal, depending on the Hemangioma’s type, size, and location. Treatment is considered if the Hemangioma poses risks or functional issues.
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