Invasive hemangioma of the head and neck

Abstract

The approach of surgeons and pathologists to the problem of hemangiomas has often been deficient in organization and authentication [1-4]. The literature abounds with clinical case reports a n d literature reviews based on pathologic location. Pack and Miller [5], in a histologically oriented article, described hypertrophic hemangiomas and defined them as the benign analog of malignant hemangioendotheliomas, noting that they are not well localized but aggressive and recurrent. Geschickter and Keasbey [4] pointed out that much of the available information about blood'vessel tumors is related to the cosmetic or symptomatic consequences of their location in the head and neck. Benign hemangiomas of the head and neck region have usually been dealt with in one of two ways. The simpler is observation of the tumor ' s growth pattern coupled with reassurance to the patient's parents that the tumor will undergo :spontaneous regression if given sufficient time. The other, followed in cases of tumor that exhibit initial rapid growth, consists of some form of radiation therapy, injection of sclerosing agents, conservative excision, and ultimately a radical surgical attack on a by now extensive tumor with considerable sacrifice of tissue. Recent experience with several cases of the latter type has stimulated us to review the cases of hemangioma of the head and neck region seen in patients of all ages by Mayo Clinic surgeons in the period from 1917 through 1969.