A hemangioma, or blood sponge, is a benign growth about whose causes little is known. Any treatment methods are varied.
What is a hemangioma (blood sponge)?
Hemangioma is an embryonal tumor that is usually benign. Hemangioma is also called a blood sponge or a strawberry patch. Hemangioma is considered the most common tumor seen in childhood. In the majority of cases, the hemangioma is found in the neck or head area, but hemangioma on internal organs (such as the liver) is also possible. In Germany, up to ten percent of newborns are affected by a hemangioma; statistically, hemangiomas are more common in girls than in boys. If a hemangioma is very extensive or covers a large part of an extremity, it is referred to in medicine as hemangiomatosis. In addition, different forms of hemangioma are distinguished. For example, there is cavernous or capillary hemangioma.
Causes
The causes that lead to a hemangioma are currently not clear in medicine. A hemangioma forms as part of a proliferation or new formation of blood vessels; not much is known about the cause of such a new formation either. Hereditary factors that contribute to a newborn developing a hemangioma are discussed; thus, a susceptibility to a hemangioma may be passed on through heredity.
Symptoms, complaints, and signs
A superficial hemangioma of the skin or mucosa is primarily manifested by elevations or bluish patches on the skin. The blue coloration increases the deeper the hemangioma sits below the skin surface. Hemangiomas that are particularly deep may resemble a bruise. A hemangioma reaches a size of a few millimeters to a few centimeters. The size may increase as it progresses before the hemangioma shrinks and disappears completely after a few months or even years. Hemangiomas usually appear shortly after birth. After a few weeks, they are fully formed and can be clearly diagnosed. They can appear in different areas of the body, but form predominantly on the face, torso and limbs. Typically, hemangiomas do not cause any symptoms. However, if they occur in the eyelid area, vision problems and problems opening the eye may occur. Hemangiomas in the armpits or in a skin fold are usually sensitive to pressure and painful to the touch. Occasionally, there is bleeding or inflammation of the affected skin. Very rarely, a hemangioma can cause circulatory problems. A large hemangioma can cause symptoms of heart failure and significantly reduce the quality of life of the affected person.
Diagnosis and progression
A hemangioma usually presents as a discoloration that appears reddish to bluish. In approximately one-third of children affected by a hemangioma, this vascular abnormality is apparent at birth. In the remaining cases, the hemangioma usually develops during the first four weeks of life. As a rule, a hemangioma does not lead to symptoms; a hemangioma on the internal organs, for example, is often not discovered at all. Often, a hemangioma regresses on its own. In these cases, a distinction is made between a growth phase, a stagnation phase and a regression phase:
The growth phase lasts up to about 9 months on average for a hematoma, while the stagnation phase is variable. The regression phase for a hemangioma is often completed by the time a child is 9 years old. Complications such as pain or bleeding may occasionally occur with a very rapidly growing hemangioma.
Complications
Because a hemangioma is a tumor, it can usually present with the various symptoms and complications of cancer. However, in most cases, it is a benign tumor, so there is no reduction in life expectancy in the patient. Patients usually suffer from skin redness and port-wine stains due to the hemangioma. The skin redness can affect the aesthetics and appearance of the affected person and often leads to inferiority complexes or reduced self-esteem.Likewise, this can lead to depression and other psychological complaints that increase the patient’s life and daily routine. It is also not uncommon for pain and bleeding to occur in the affected areas, which can reduce the patient’s quality of life. Especially at night, pain can lead to sleep difficulties. In many cases, the hemangioma only forms in children and usually heals on its own, so there is no discomfort in adulthood. Scarring may occur during treatment. However, no other complications occur.
When should you see a doctor?
A hemangioma should always be treated by a doctor. Although it is a benign growth, it should be removed because it can turn into a malignant tumor. Early diagnosis and treatment always has a positive effect on the further course of the disease and can prevent complications. The affected person should consult a doctor if there is redness on the skin due to the hemangioma. These can occur in different places. Furthermore, port-wine stains can also indicate the hemangioma. Therefore, if the symptoms occur without any particular reason and persist for a long period of time, a visit to a doctor is highly advisable. As a rule, a general practitioner or directly a dermatologist can be consulted in case of a hemangioma. Whether treatment is necessary depends on the severity of the hemangioma and cannot be generally predicted. However, in most cases there is a positive course of the disease and no particular complications.
Treatment and therapy
Because a hemangioma often resolves on its own, therapy is not necessary in many cases. Treatment of a hemangioma can be done, for example, if it is desired by the affected person for cosmetic reasons (or if it is desired by parents whose child has a hemangioma). One way to treat a hemangioma is with laser therapy. A very small and flat hemangioma can also be treated, for example, with cold therapy called cryotherapy. Here, cold is used to remove a blood sponge. However, the method of cryotherapy has the disadvantage that scars may appear as a result of the treatment. Experts often advise against surgery to remove a hematoma. However, surgery may be useful if other methods have not been successful or if it is a rapidly growing hemangioma that threatens to affect the function of other body structures (such as a hemangioma in the immediate vicinity of the eye). In some cases, it may also be useful to treat a hemangioma with medication; for example, if an affected person has multiple hemangiomas or suffers from hemangiomatosis. Corticosteroids are used here, for example. Such treatment usually lasts several weeks. The treatment of hemangioma is usually carried out in such a way that the drug dose is quite high at the beginning of the therapy and the dose is reduced during the course of treatment. In complicated cases, hematoma may also be treated with beta-blockers.
Prevention
In principle, it is not possible to prevent a hemangioma because too little is still known about the mechanisms of its development and the causes behind it.
Follow-up
Follow-up care for hemangiomas depends on the previous therapy. If it is a hemangioma that was surgically removed due to its location or spread, the usual aftercare following surgery must be followed. This includes a regular outpatient wound check and a check whether the hemangioma has been completely removed. In the acute aftercare, there is also a medicinal accompaniment with painkillers. In the case of non-operative follow-up and larger hemangioma, the treatment with propranolol is monitored by a general practitioner or pediatrician. At the same time, a check is made to see if the propranolol is working and there is regression of the hemangioma. Follow-up includes checking whether the dosage of propranolol is sufficient and the patient is still properly adjusted. This helps prevent over- or under-dosing. Since propranolol is a beta-blocker for cardiovascular disease, regular monitoring is necessary. Follow-up with propranolol lasts about six months to a year.If, due to the size and location of the hemangioma, neither surgical follow-up nor propranolol treatment is performed, the hemangioma will usually regress on its own. Nevertheless, this process should be followed up as part of general medical follow-up to rule out enlargement or complications during regression.
What you can do yourself
Smaller hemangiomas are usually harmless and regress on their own after some time. In children, however, the lump must be watched very closely. If the hemangioma does not regress even after several months or even increases in size, it is necessary to see a doctor. If it is a benign hemangioma, it does not need to be removed. However, at some point the child will wonder about the lump and may suffer emotionally. Then either a surgical intervention is considered or – if an operation is too risky – the child must at least be explained what the sponge is all about. The regression of a hemangioma can be promoted by various natural remedies. For example, calendula and cypress, but also Swedish herbs and houseleek have proven effective. A suitable remedy from homeopathy is the boar’s rue called Abrotanum. The use of these remedies should be discussed with the doctor in any case. The doctor may even consult an experienced alternative practitioner. If the hemangioma causes complications, conservative treatment is always necessary.
