Vascular Tumors

Abstract

Vascular anomalies are divided into tumors (proliferating endothelium) and malformations (quiescent endothelium), with tumors comprising the spectrum from benign to aggressively malignant. Ninety percent of vascular tumors can be accurately distinguished by history and physical exam. Infantile hemangioma is the most common tumor of infancy. It undergoes rapid postnatal growth followed by involution during childhood. Most infantile hemangiomas are simply followed without therapy; aggressive tumors or those in critical locations can be treated pharmacologically or resected. Congenital hemangioma is a rare lesion arising in the fetus. Such tumors are fully developed at birth and do not demonstrate the postnatal growth characteristic of infantile hemangioma. There are two types of congenital hemangioma: rapidly involuting congenital hemangioma immediately begins involution after birth, while noninvoluting congenital hemangioma never regresses. Kaposiform hemangioendothelioma is a vascular neoplasm that is locally aggressive, but does not metastasize. It proliferates through early childhood but partially regresses into mid-childhood. Pyogenic granuloma is a solitary, red lesion that grows rapidly on a stalk. Unlike the other pediatric vascular tumors, pyogenic granuloma rarely appears during the first month of life. Kaposi sarcoma is a malignant tumor often associated with human herpes virus 8. Angiosarcoma is a rare endothelial lesion of either vascular or lymphatic origin.