Hemangioma and Vascular Malformations
What are Hemangioma and Vascular Malformations?
A hemangioma is a benign mass of abnormal blood vessels that can form anywhere in the body. It usually appears as a small patch, then grows rapidly over the first year of life.
They tend to grow rapidly for the first year and then slowly shrink over time without treatment. Most hemangiomas leave little trace by 5-10 years of age. For this reason, surgery to remove a hemangioma is rarely needed.
Port Wine Stains
Port wine stains, also known as capillary malformations (CM), are flat, pink or red patches of skin caused by abnormal capillaries (the tiniest blood vessels) within the skin. Three in every 1,000 babies are born with a port wine stain. Unlike hemangiomas, port wine stains grow slowly with the child and do not go away over time. Instead, they tend to become darker and may develop a thickened, “cobblestoned” appearance without treatment. Laser therapy can be helpful to lighten the color of port wine stains and prevent them from thickening.
Babies with large port wine stains of the face may be at increased risk for eye problems, seizures and developmental delay (Sturge-Weber syndrome). Your child’s doctor can help decide when a port wine stain requires further workup.
Venous malformation (VM)
A venous malformation is an abnormal collection of veins that can form anywhere in the body. It can shrink and swell throughout the day. Sometimes it can discomfort, especially if there are clots (phleboliths) inside it.
Lymphatic malformation (LM)
A lymphatic malformation is an abnormal collection of lymphatic vessels that can form anywhere in the body. It can grow when the child has a viral illness. Sometimes, there are vesicles on the skin that leak fluid.
Arteriovenous malformation (AVM)
An arteriovenous malformation is a collection of blood vessels with an abnormal connection between an artery and a vein. It may pulsate and feel warm to the touch. It can cause wounds and pain.
How are Hemangioma and Vascular Malformations Diagnosed?
Babies with multiple hemangiomas of the skin may also have internal hemangiomas, in the belly, for example. Large hemangiomas on the face or middle of the back may be related to other problems, such as heart defects or spinal abnormalities. Your child’s doctor can help recognize these types of hemangiomas and perform further testing, when necessary.
How are Hemangioma and Vascular Malformations Treated?
The treatment of a hemangioma is usually observation. Some hemangiomas can cause problems if they bleed or press on important nearby structures, such as the eye or the upper airway. In these high-risk situations, medications are prescribed to help rapidly decrease the size of the hemangioma. These medications have risks and side effects of their own, so treatment is reserved for hemangiomas that are truly high-risk. There are also certain situations where a hemangioma may be resected.
Venous malformations, lymphatic malformations and arteriovenous malformations require a multidisciplinary approach by several specialists. The treatment may consist of:
- Sclerotherapy: injection of medication through the skin into the lesion)
- Embolization: treatment of the lesion with catheters threaded through large vessels into the lesion
At Nationwide Children’s Hospital, our Hemangioma and Vascular Malformations team consists of several specialists who are dedicated to diagnosing and treating these lesions. Our specialists include:
- Plastic surgeons
- Interventional radiologists
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