Hemangioma
Description of Hemangioma
While it can be a minor birth defect, having a child with a hemangioma can be frightening for some parents. A child born with a hemangioma is more likely to be female, premature or to be born as a twin or triplet. A hemangioma begins as a small strawberry mark on a child’s face or other body part. A hemangioma is a collection of blood vessels that has grown out of control, forming a raised, red birthmark.
When children with a hemangioma are babies, the hemangioma tends to grow over time. Parents become frightened when, by the age of one year, the child’s hemangioma has become quite large. In some cases, the hemangioma is so disfiguring and fails to regress; hemangioma surgery may be required.
A doctor who specializes in hemangioma surgery will look at the child’s hemangioma and decide if it can be removed through hemangioma surgery or if the hemangioma is likely to resolve on its own. Doctors like to do hemangioma surgery before the child suffers too much from other children teasing him or her about the hemangioma. Sometimes tests are done to see how extensive the hemangioma has become before proceeding with hemangioma surgery.
What to expect during and after a hemangioma surgery
At the time of hemangioma surgery, doctors are careful to remove all of the hemangioma tissue so that no aspect of the hemangioma can grow back. The doctor is also careful to be certain that the child doesn’t lose too much blood at the time of hemangioma surgery because a hemangioma is an extremely vascular lesion. Cosmetics are important in hemangioma surgery as well. The doctor makes sure that the child will look better after hemangioma surgery than before.
After the hemangioma surgery is over, the parents must keep the wound clean, dry and free of infection. The child may be used to touching the hemangioma and may want to get under the bandages. The benefits of the hemangioma surgery will be lost if the child picks at the wound before it is healed.
When the hemangioma is removed and the wound heals, the child will have a small scar where the hemangioma used to be. After this heals, the child’s disfigurement from the hemangioma should be gone forever. In rare cases, the hemangioma could reoccur to some extent. In that case, hemangioma surgery may need to be repeated.
What Is A Hemangioma?
A Hemangioma is an unusual build up of blood vessels in the skin or the internal organs. They either appear in the form of a birthmark or during gestation. They are usually present and observed within two or three months of infancy. Almost 10% of infants suffer from this disease and they are more common in females than males. Hemangiomas can be vivid superficial lesions or appear as a bluish swelling, if present under the skin. The lesions can be both superficial and deep. About 80% of these marks appear on the face, neck and around the liver area.
Signs, Symptoms and Treatment Options
Sometimes, hemangiomas disappear without any treatment, leaving minimal marks. But, some large hemangioma might involve prominent skin texture changes or damage. The problem intensifies when it interferes with vision or breathing. Superficial hemangiomas sometimes are not treated and are allowed to disappear with the passage of time. However, in certain severe cases, laser therapy can be used to remove the elevation of small blood vessels. Cavernous hemangiomas that affect the vision are treated with steroid injections or lasers, to reduce the size of the lesions and allow the normal development of vision.
By far, Cutaneous Hemagiomas are the most common in infants and children. Intralesional bleomycin (or BLM injection), is the latest treatment development. This injection produces extensive destruction and spontaneous resolution of the hemangiomas.
New Treatment Developments
Corticosteroid therapy is one of the main treatments. It is an anti-inflammatory medication that can be given orally or locally injected. But, it can include a number of risks, including poor growth in children and elevated blood sugar if administered orally. It is often suggested for long-term use. If corticosteroids do not work, other drugs like interferon or vincristine are considered. Tracheotomy, often known as tracheostomy, is also used in the treatment of hemangioma on the neck. In this surgery, a direct airway is opened through an incision in the trachea. It is generally performed if a blockage of the airway occurs.
Recently, with the development of laser technology, incidences of hemangioma have been reduced significantly. Lasers emitting yellow light damage the vessels in the hemangioma, without damaging the skin. A dye laser is a laser treatment that incorporates an organic dye as a lasing medium, generally as a liquid solution. The dyes have wide bandwidth that makes them suitable for tunable and pulsed lasers.
Many physicians use a combination of steroids, lasers and injections to cure hemangiomas.
Cutaneous hemangiomas are the most common tumors in infants and children. Apart from its unaesthetic appearance, approximately 5% produce complications such as bleeding and infection. A new type of treatment for complicated cutaneous hemangiomas is the intralesional bleomycin (BLM) injection, which provides considerable relief. BLM injection is simple, and is a very useful treatment for complicated cutaneous hemangiomas.
Cavernous hemangiomas that involve the eyelid and obstruct vision are generally treated with steroid injections or laser treatments, which rapidly reduce the size of the lesions, allowing normal vision to develop. Large cavernous hemangiomas or mixed hemangiomas are treated, when appropriate, with oral steroids, and steroid injections directly into the hemangioma.
These days, lasers are being used to treat the bulk of hemangiomas. Lasers emitting yellow light selectively damage the blood vessels in the hemangioma, without damaging the overlying skin. Some physicians use a combination of steroid injections and laser therapy to treat the condition.
Hemangiomas on the face or neck should be treated as soon as they are discovered, to prevent them from becoming a major problem later. However, finding a qualified physician to treat this problem can be difficult, and generally family physicians and pediatricians are not familiar with the treatment of vascular bithmarks. That is why referral to a specialist is often necessary to explore effective treatment options.
The treatment of infant hemangiomas depends on the child’s growth and development. The following treatments may be needed:
- Medications for heart failure
- Embolization of the liver (blocking blood flow to the hemangioma)
- Ligation of the liver artery
- Surgery to remove the tumor
With early diagnosis and treatment, a child with a hemangioma can have a normal and happy life without the stigma of disfigurement.
