Hemangioma: Description
A hemangioma is a benign tumor of the blood vessels (angiodysplasia) that can be located at different depths in the skin. It is also known colloquially as a hemangioma or hemangioma. Hemangiomas do not form metastases, but their growth can press against organs and cause symptoms.
Hemangioma: types and frequency
A hemangioma occurs in infants and is either present from birth (congenital hemangioma) or develops in the first weeks of life (infantile hemangioma). The latter is more common than the congenital variant.
Girls are affected by hemangiomas about three times more frequently than boys. Around five percent of full-term babies and over 20 percent of premature babies have an infantile hemangioma.
A lymphangioma is similar to a hemangioma. The difference is that a lymphangioma develops from lymph vessels.
Hemangioma: Symptoms
Hemangiomas are mainly found in the skin. Parents notice them as red-blue spots, patches or lumps on their baby. Hemangiomas can be flat or raised. The infantile hemangioma develops in the first four weeks of life. It can then grow until around the ninth month of life.
Hemangioma: causes and risk factors
The exact mechanisms that lead to hemangiomas have not yet been conclusively clarified. However, hemangiomas occur more frequently in some families, which indicates a hereditary component in the development of hemangiomas.
If someone has more than ten hemangiomas, this is referred to as hemangiomatosis. Hemangiomas are also frequently found on internal organs (e.g. liver, brain, lungs or gastrointestinal tract), so that further examinations are necessary. Genetic syndromes such as Kasabach-Merritt syndrome can also be associated with increased hemangiomas. In addition to the formation of large hemangiomas on the extremities, there is also a drop in the blood platelet count (thrombocytopenia).
Hemangioma: examinations and diagnosis
If you notice a red spot on your child’s skin, the pediatrician is the right person to contact. They will ask you in detail about your child’s medical history (anamnesis). They will ask you the following questions, among others:
- When did you first notice the skin change?
- Has the size or color changed since then?
- Does or did someone in your family already have a hemangioma?
Further examinations
The medical history and clinical examination are decisive in making a diagnosis of hemangioma. The hemangioma should then be photodocumented in order to detect changes over time.
In addition, further examinations are necessary in some cases. These include an ultrasound examination (sonography). This can be used to detect hemangiomas in the abdomen, for example in the liver. Magnetic resonance imaging (MRI) can be used to diagnose hemangiomas in the brain.
Hemangioma: treatment
There are various ways to treat a hemangioma. The choice of method depends primarily on where the hemangioma is located and how large it is. Rapid treatment is advisable if the tumor restricts the function of organs such as the eye, ear, nose, mouth, feet or hands.
Some hemangiomas should also be treated early for cosmetic (on the face) or nursing reasons (in the genital area).
Cold and laser therapy
Laser therapy with a dye laser (FPDL) or pulsed flash lamp (IPL) can also be used for very small hemangiomas. However, it has now taken a back seat to the highly effective drug treatment with propranolol.
Medication
If someone has a larger hemangioma or several hemangiomas, they are often treated with medication, namely with the active ingredient propranolol. This is a beta-blocker – a vasoconstrictor drug that is normally used to treat cardiovascular diseases. It has been officially approved for hemangioma therapy since 2014 because it was discovered by chance that it also works quite well against hemangiomas.
Propranolol should be administered under inpatient supervision. The dose is initially very low and is then slowly increased to avoid cardiovascular disorders. In addition, the patient’s heart must be examined using electrocardiography (ECG) and cardiac ultrasound (echocardiography) before starting therapy. This is to rule out the possibility of heart disease, which would be an argument against treatment with propranolol.
In the past, hemangiomas were also treated with glucocorticoids (cortisone) or chemotherapeutic agents, but this is now considered outdated.
Surgery
Additional measures
Infantile hemangiomas are accompanied by ulceration in the anus or genital region? Then – in addition to propanolol therapy – a care concept that dries out the lesion can be helpful: after each urination or bowel movement, the affected area is rinsed with disinfectant (octenidine dihydrochloride) and then allowed to air dry. Then apply an antiseptic (polyhexanide) to the sore area and cover it with a sterile kerosene gauze dressing.
Black tea compresses can also be used to dry out the area.
Hemangioma: course of the disease and prognosis
The prognosis is good. Infantile hemangiomas usually disappear on their own between the end of the first year and the ninth year of life. Often no residue remains visible. However, particularly large hemangiomas may remain:
- scars
- swelling
- Pigment change
- Thinning of the skin
A congenital hemangioma is more likely to persist than an infantile hemangioma. With the right therapy, however, it can be completely eliminated.
