A hemangioma is a patch of blood vessels that has grown out of proportion to the surrounding tissues. They are considered tumors, although they are by definition benign. The endothelium, or inner lining of the blood vessels, grows faster than normal, causing the blood vessels to spread and multiply. Hemangiomas are fairly common, especially among Caucasian girls, and are even more common in premature infants.
Infantile Hemangiomas
This type of hemangioma grows rapidly during the first year of life and then slowly regresses over the next five to 10 years. Occasionally, they may be large enough to be cosmetically disfiguring, or may interfere with crucial structures of the body. The reason they occur is unknown. A 1990 research study published in "American Journal of Medical Genetics" observed that babies of mothers who had chorionic villus sampling, a technique where the placenta is tested during the pregnancy, were more likely than other babies to have an infantile hemangioma. In fact, according to research published in "Early Human Development" in 2006, some of the proteins that can be found on placental tissue are also found on hemangiomas, and the presence of these markers can be used to differentiate infantile hemangiomas from other types of birth marks.
Superficial Infantile Hemangiomas
You may notice a discolored or light patch on your newborn baby's skin that becomes a bright red color over the first month of life. This appearance has led to the alternate name of "strawberry nevus." This hemangioma can be wrinkly like a walnut shell or smooth. A superficial hemangioma is limited to the outer layers of skin and is most likely to occur on the head or face, but may occur anywhere on the body. These hemangiomas are typically harmless and present only cosmetic concerns, although a hemangioma near the eye, for instance, could potentially interfere with the child's ability to see. Unless the hemangioma presents a physical problem, the typical approach is to wait for it to spontaneously regress.
Deep Infantile Hemangiomas
Some hemangiomas occur in the deeper skin layer, the dermis, and extend into the fat and connective tissues. These deeper varieties have the added risks of interfering with internal organs and body functions. For instance, a deep hemangioma in the neck could interfere with the airway or with blood supplies to the brain. The majority of deep hemangiomas do not require treatment. If it causes problems with sensory or internal functions, there are a few options available, such as oral steroids or propranolol. Laser therapy is not typically effective.
Congenital Hemangiomas
Congenital hemangiomas are fully present at birth. Like infantile hemangiomas, they may spontaneously regress, and these are called rapidly involuting congenital hemangiomas, or RICH for short. Another subtype, called non-involuting congenital hemangiomas, or NICH, continues to grow over time. These hemangiomas do not respond to steroids and are more likely to require surgery.
Internal or Visceral Hemangiomas
On occasion, infantile or congenital hemangiomas can occur further inside the body and involve vital organs such as the liver. They pose a higher risk of interfering with body function, and may require a more invasive treatment approach, such as surgery.
References
- "Pediatrics"; Hemangiomas; Joseph Morelli, M.D.; August 2007
- "Early Human Development"; Infantile Hemangiomas; David J. Atherton, M.A., M.B.; December 2006
- "American Journal of Medical Genetics"; Malformations and Minor Anomalies in Children Whose Mothers Had Prenatal Diagnosis: Comparison Between CVS and Amniocentesis; Paige Kaplan, Ph.D et. al.; November 1990
- "Human Pathology"; GLUT1: A Newly Discovered Immunohistochemical Marker for Juvenile Hemangiomas; Paula E. North, M.D., Ph.D. et. al.; January 2000
- "New England Journal of Medicine"; Propranolol for Severe Hemangiomas of Infancy; Christine Léauté-Labrèze, M.D. et. al.; June 2008
