Patient's question:
2-month-old baby patient age:Doctor's answer:
This is considered to be a hemangiomaDisease Name
Hemangioma
Disease Overview
A tumor arising from vascular tissue is called a hemangioma, of which 80% are congenital. Hemangiomas are benign, grow slowly, and rarely transform into malignancy.
Capillary hemangioma: It is formed by superficially dilated, tortuous, and meandering capillaries. It is most common in infants, with most being female. Red spots or small macules can be observed on the skin at birth, which gradually enlarge, darken in color, and become elevated. The growth rate of capillary hemangiomas is often faster than the infant's development. The tumor boundary is distinct, and it can slightly blanch under pressure and return to red after releasing pressure. It can be treated with cryotherapy, surgical excision, or X-ray irradiation.
Cavernous hemangioma: It is generally composed of small veins and adipose tissue. Its morphology and texture resemble a sponge, hence the name cavernous hemangioma. Most grow in subcutaneous tissue, but they can also occur in muscles, and rarely in bones or internal organs. Subcutaneous cavernous hemangiomas may cause mild local elevation, normal skin, or a bluish-purple appearance. The mass is soft and well-defined. Treatment should involve early surgical excision. Small cavernous hemangiomas can also be treated with local injection of vascular sclerosants (e.g., 5% sodium squalene oil).
Hemangiomas are common benign tumors in childhood. About 3/4 of pediatric hemangiomas exist at birth, and the rest appear within the first year of life, with female infants being more common than male infants.
Embryonic vascular tissue is often retained in parts of an infant's body, and these tissues grow abnormally, forming different types of hemangiomas. They still have normal tissue structure, but the number, distribution, and morphology of hemangiomas differ from normal tissue. Hemangiomas are most common on the face and limbs, affecting aesthetics. They can also cause bacterial infections due to trauma, friction, or scratching. Some hemangiomas grow rapidly at first, then slowly, and may even disappear spontaneously. Parents should closely monitor the growth of infant hemangiomas, provide home care, and identify the best time for treatment.
Disease Classification
Oral and Maxillofacial Surgery
Disease Description
Hemangiomas are most commonly seen in infants at birth (about 1/3) or shortly after birth (within one month). They originate from residual embryonic angioblasts. Their histopathological features include abundant, actively proliferating vascular endothelial cells within the tumor, along with angiogenesis and aggregation of mast cells. Hemangiomas occurring in the oral and maxillofacial region account for about 60% of all hemangiomas, with most occurring on the facial and neck skin or subcutaneous tissue, and very rarely on oral mucosa. Deep and intra-osseous hemangiomas are currently considered to belong to vascular malformations.
Common Types
◎ Orange spot: Present at birth, with varying sizes, orange-red or pale red in color, not elevated above the skin surface, and blanching under slight pressure. The color deepens during crying. Orange spots are most common on the forehead, upper eyelids, and occipital region. They usually disappear within a few months after birth and require no treatment.
◎ Nevus flammeus (port-wine stain): Present at birth, appearing as pale red or dark red patches, which do not blanch under pressure, are not elevated above the skin surface, and are located in the dermis, composed of a capillary network. After birth, the size of nevus flammeus increases proportionally with the body, but the range does not expand further. Nevus flammeus does not spontaneously regress. Besides affecting aesthetics, it generally poses no other harm. Cryotherapy may be used if necessary.
◎ Capillary hemangioma: Most commonly found on the skin, with the most frequent locations being the occipital region, face, limbs, and back. Many occur on the lips and tongue. Capillary hemangiomas vary in size, with larger ones occupying a significant portion of the face or limbs, and smaller ones only a few millimeters in diameter, slightly elevated above the skin. They are usually present at birth and grow rapidly within the first six months, then gradually stop growing after the age of two. They affect aesthetics and carry the risk of severe bleeding if damaged. Parents should closely monitor them. If the hemangioma is small and grows slowly, not in a visible area, it may spontaneously regress after stopping growth. If the hemangioma grows rapidly and significantly affects aesthetics, immediate treatment should be considered, such as isotopic.
◎ Cavernous hemangioma: Can occur on the skin, subcutaneous tissue, muscles, or even in the liver, kidneys, etc. It appears purplish-red and has tortuous, dilated small veins around it. It feels soft and elastic, and shrinks under pressure and returns to normal after releasing pressure. This type of hemangioma grows with the infant's age and can sometimes become very large and deep, severely affecting aesthetics and damaging normal tissue. Once diagnosed, immediate treatment should be administered, such as injection of sclerosants or surgical excision.
◎ (Angiofibromas): Most commonly found on the limbs, with many branching, dilated blood vessels on the surface and surrounding area, appearing as a creeping, tortuous pattern. The local skin may appear dark red or bluish-purple, and sometimes a blood vessel pulsation or bruit can be felt. Early surgery should be considered for this type of hemangioma. Elastic bandages can also be used to wrap the limbs to alleviate symptoms such as pain.
Diagnosis and Examination
The diagnosis of vascular or angiomas is not difficult. For deeper hemangiomas or angiomas, positional mobility tests and puncture may be required.
Treatment Plan
The treatment of vascular or angiomas depends on the type, location, and age of the patient. Current treatment methods include surgical excision, radiation therapy, hormone therapy, cryotherapy, laser therapy, and sclerosant injection. Generally, a combination of therapies is used. For infants with hemangiomas, observation is recommended, and timely intervention should be provided if rapid growth occurs.
Basic Knowledge
Hemangioma is a benign tumor that occurs in vascular tissue, formed due to the abnormal development and tumor-like proliferation of vascular tissue. It is divided into primary and secondary types, with primary accounting for about 75% and secondary for about 25%. Secondary hemangiomas mostly appear in infancy, while a few are discovered in adulthood, with the cause still unclear. Primary hemangiomas, also known as congenital hemangiomas, are formed due to the proliferation of vascular networks during the embryonic stage and are present at birth. Small hemangiomas may be asymptomatic. Hemangiomas can occur in various parts of the body, particularly on the face and limbs, affecting aesthetics. They can compress and damage the function and morphology of surrounding tissues and organs, affecting human growth and development. Some may bleed repeatedly or become infected, and in rare cases, they may transform into malignancy, even endangering life.
In traditional Chinese medicine, hemangiomas are believed to be caused by internal heat and toxicity, excessive heart fire, abnormal blood flow, leading to chaotic qi and blood, entangled meridians, and the formation of masses that manifest on the skin or internal organs. Treatment: Cool blood, resolve stagnation, clear heat, and nourish yin.
Early treatment is recommended for hemangiomas, with better efficacy and prognosis the earlier it is treated.
Related Information
1. Surface Hemangiomas:
- Affect aesthetics: Surface hemangiomas can occur on any part of the body, but are most common on the face, neck, torso, and limbs. Due to their red, black, or bluish color, irregular or convex shape, or dilated and winding appearance, they severely affect aesthetics, causing significant physical and psychological harm to patients.
- Risk of severe bleeding: They can cause severe bleeding due to trauma, compression, or scratching, leading to continuous blood flow.
- Damage surrounding tissues: They can damage surrounding tissues, causing deformities and affecting function.
- Abnormal skeletal growth: They can affect skeletal development.
- Ulceration of the tumor:
- Severe limb deformity:
- Genetic inheritance:
2. Internal Hemangiomas:
- Hepatic hemangiomas are actually congenital developmental abnormalities caused by the proliferation of hepatic vascular endothelial cells or secondary vascular dilation. They are the most common benign tumors of the liver. Based on the amount of fibrous tissue, they can be classified as (sclerosing hemangioma), (angioendothelioma), (angiofibroma), capillary hemangioma, and cavernous hemangioma, with the latter being the most common.
- This condition is more common in females and can occur at any age, either as a single lesion or multiple lesions, in either the right or left liver. The size of the tumor varies, with smaller ones only visible under a microscope and larger ones weighing over 20 kilograms. The course of the disease can last for decades.
- Main hazards:
- Upper abdominal discomfort: As the tumor grows or compresses the stomach and intestines, it can cause upper abdominal discomfort, bloating, and nausea. In severe cases, it can lead to deformation and functional damage of the stomach and intestines.
- Spontaneous rupture: Large hemangiomas on the liver surface can rupture spontaneously, causing severe intra-abdominal bleeding and endangering life.
- Transformation into malignant hemangioma:
- Liver pain and psychological stress: