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What is a hemangioma?

What is a hemangioma?

Hemangioma is a benign tumor of the endothelial cells – the cells which line the blood vessels. Benign hemangioma of skin or cutaneous hemangioma is characterized by its red appearance due to increased number and swelling of blood vessels. Skin hemangioma can arise out of superficial or deep layers of the skin, or be mixed.

Hemangiomas usually appear after first few weeks of birth and are called infantile hemangiomas or hemangioma of infancy. Hemangioma can also appear as a hemangioma birthmark, which is present at birth and does not have strong tendency to self-involute. If a baby hemangioma presents on superficial layers of the skin of a newborn then it is called superficial hemangioma, strawberry hemangioma, red hemangioma or capillary hemangioma, if it is present in the deeper layers of the skin, such as dermis or subcutaneous layer, then it is called deep hemangioma of the infant or cavernous hemangioma of the skin. Also, hemangiomas can be internal, examples of internal hemangiomas are: liver hemangioma, spinal hemangioma, bone hemangioma, brain hemangioma and intramuscular hemangioma.

If a hemangioma arises out of veins it is called venous hemangioma or blue hemangioma. Infantile hemangiomas are different from hemangioma in adults because infantile hemangiomas treatment is not necessary as they are self-involuting - usually reaching their maximum size after five months and completely disappearing after five to twelve years.

Some common hemangiomas that usually require treatment are facial hemangiomas:

  • eye hemangioma, 
  • eyelid hemangioma, 
  • lip hemangioma.

Hemangioma treatment options for hemangioma on neck and facial hemangioma treatment, hemangioma lip treatment and oral hemangioma include drugs like steroids, beta blockers and surgery and can also include drugs like interferon and vincristine.

What causes a hemangioma?

It is not clear what causes the increased density of extra blood vessels. Hemangiomas develop in every one out of ten babies. It is suspected that a hereditary component is involved since hemangiomas occur more often in white babies, premature babies and girls. Estrogen is suspected to play a role in the development of hemangiomas since women using estrogen therapy and pregnant women have a higher chance of developing large hemangiomas instead of small hemangiomas.

Hemangioma diagnosis

A hemangioma can be diagnosed by a doctor by just looking at it. Hemangioma tumors are benign. If a doctor is not sure of the diagnosis or is suspicious of other symptoms he may advise to do a skin biopsy or a blood test. Common places for a superficial hemangioma are:

  • hemangioma on scalp, 
  • hemangioma of head, 
  • hemangioma on arm, 
  • finger hemangioma.

Hemangioma pictures can be obtained by cavernous hemangioma MRI or CT scans that are used to examine a deep hemangioma or cavernous hemangioma. Ultrasound is used to examine the blood flow of hemangioma using Doppler technique.

Treatment for hemangioma

Treatment of a baby’s hemangioma is usually not necessary as it often disappears after some time. Cavernous hemangioma treatment can be necessary if it bleeds, causes discomfort or is located around eyes, mouth or nose. Capillary hemangioma treatment is not necessary as often as cavernous hemangioma treatment. Common treatments for hemangioma include: beta blocker drugs, corticosteroid medications and laser surgery. Hemangioma treatment for adults does not differ substantially from children but hemangioma surgery is employed more often and sooner during treatment.

Can hemangioma be removed?

Hemangiomas removal is usually not necessary unless a cavernous hemangioma is in an area around the eyes, nose or throat. Treatment might also be necessary if hemangioma ulcerates or is very large. Strawberry hemangioma treatment is rarely necessary.

Hemangiomas in liver

Liver hemangioma is a benign tumor in the liver made up of blood vessels; it is sometimes called cavernous hemangioma or hepatic hemangioma. Hemangioma of the liver does not usually cause any symptoms or require any treatment. It is the most common primary tumor of the liver. Liver hemangiomas symptoms can present if a hemangioma in liver becomes large and can cause nausea, liver hemangioma pain in abdomen, lack of appetite.

Liver hemangioma treatment can include:

  • cavernous hemangioma surgery, 
  • surgery to remove part of the liver, 
  • liver transplant, 
  • radiation therapy.

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Vertebral hemangioma

Hemangiomas in spine are the most common benign vertebral neoplasm or osseous hemangioma. Most common regions for hemangioma of spine are the thoracic hemangioma and lumbar hemangioma. Multiple hemangiomas occur as commonly as atypical hemangiomas of the spine that are hypointense in T1, but retain typical characteristics in T2 window of MRI.

Hemangioma’s of spine symptoms are usually non-existent. Collapse of vertebral body causing compression of spinal nerves is one of the most common symptoms if they appear.

Vertebral hemangioma treatment is not necessary for most hemangiomas. If neurological symptoms present - a proper therapy can be chosen from a multitude of options, such as radiotherapy, trans-arterial embolization, etc.

Cerebellar hemangioma

Hemangioma in brain localizes most often in the lowest parts of the brain – cerebellum and brain stem. These hemangioma tumors have clearly defined borders and are self-limiting.

Hemangioma brain symptoms include headache, nausea, poor coordination and vomiting. Symptoms depend on the location of the tumor. Ulcerated hemangioma is one of the biggest complications.

Treatment of cavernous brain hemangioma is surgical and radiologic if necessary.

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