Abstract
We believe that spontaneous involution of the most common hemangiomas of infancy and childhood must be accepted as a fact. However, in some cases involution progresses slowly, while in a small percentage regression does not occur. When surgery is forced by parental pressure (Fig. 6) and is attempted during the growing phase of the large involuting type of hemangioma, it can rarely be completely excised and growth will continue in the residual vascular tissue until the latent period is reached. If operation is delayed until involution has started, then one may perform a more conservative excision, as the residual vascular tissue will involute spontaneously. If early therapy is required to placate the parents, some homeopathic method of treatment at infrequent intervals should be carried out. It is also recognized that plastic surgery is necessary to remove the residual cosmetic disfigurements of the large hemangioma in the preschool period. However, surgery which is performed after a number of years following the involution of large hemangiomas is much simpler and less dangerous than when attempted in infancy. Furthermore, we believe that radical methods of treatment which may damage or prevent the growth of normal tissues are contraindicated. A discussion of the treatment for the non-involuting types of hemangiomas is presented.
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