Abstract
Hemangiomas are common benign vascular tumors that often present in childhood. Diagnosis is based on clinical history, physical examination, and, when unclear, assisted with ultrasound or MRI. While the majority are small, nonproblematic, and can be managed conservatively, some hemangiomas may be associated with underlying syndromes or concerning for visceral involvement. Symptomatic lesions may develop ulceration, bleeding, vision disturbances, functional limitations, or disfigurement. The ideal treatment for a symptomatic hemangioma is often multimodal and may vary depending on the size, location, and proximity to critical structures. Medical treatments include topical beta blockers, oral propranolol, or steroid injections. Surgical resection and laser therapies may be necessary to optimize long term outcomes.
Highlights
Infantile hemangiomas (IHs) are benign vascular tumors that are common in children
IHs express GLUT1, a receptor found on placental blood vessels, which has led to a theory that they may be caused by abnormal implantation of progenitor cells disrupted from the placenta during fetal development[4]
Hemangiomas are congenital vascular lesions divided into congenital and infantile subtypes
Summary
Infantile hemangiomas (IHs) are benign vascular tumors that are common in children. They are present in an estimated 5% of the population and are characterized by abnormal proliferation of endothelial cells and abnormal blood vessel structure[1]. Segmental hemangiomas are larger plaque-like lesions that may follow dermatomal distributions, often develop ulcerative complications, and demonstrate prolonged proliferation and involution phases. They are associated with syndromes that require additional work-up. Laser therapy is a treatment option typically used for persistent telangiectasia or residual lesions during or after hemangioma involution. Hemangiomas with a significant vertical growth pattern are at higher risk of leaving undesirable fibrofatty residuum after involution, which can be addressed with surgical excision[22] This is common in scalp IHs, which may develop alopecia during the involution phase and are excised with primary closure[23]. While not every hepatic hemangioma needs treatment, screening in these high-risk children has been shown to significantly reduce the risk of congestive heart failure, hypothyroidism, abdominal compartment syndrome, and mortality[24]
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