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, gradually increasing in size, deepening in color, and becoming elevated. The growth rate of capillary hemangioma is often faster than the infant's development. The boundaries of the tumor are 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 appearance and texture resemble a sponge, hence the name cavernous hemangioma. Most grow in subcutaneous tissue, but they can also be found 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 with clear boundaries. 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.
Infant tissues often retain embryonic vascular tissue, 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 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 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 skin and subcutaneous tissue of the face and neck, and very few on oral mucosa. Deep and intraosseous 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 slightly under light 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 nevus flammeus grows proportionally with the body but does not expand further. It does not disappear spontaneously. 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 grow 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 usually exist from birth and grow rapidly within the first six months, then gradually stop growing after two years. 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 exposed area, it may disappear spontaneously 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 with tortuous, dilated small veins around it. It feels soft and elastic, and shrinks under pressure, returning to normal after releasing pressure. This type of hemangioma grows with the infant's age and can become very large and deep, severely damaging aesthetics and disrupting 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 blue-purple, and sometimes blood vessel pulsation or vascular murmurs 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 vascular or angiomas, positional mobility tests and puncture should be performed.
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 infant hemangiomas, observation should be conducted, and timely intervention should be provided if rapid growth occurs.
Basic Knowledge
A hemangioma is a benign tumor that occurs in vascular tissue, formed due to the abnormal development and proliferative growth of vascular tissue. It is divided into primary and secondary types, with primary accounting for about 75% and secondary for about 25%. Secondary hemangiomas usually appear in infancy, with a few found in adulthood, and their cause is unclear. Primary hemangiomas, also known as congenital hemangiomas, are formed due to the proliferation of vascular networks during embryonic development and are present at birth. Small hemangiomas may be asymptomatic. Hemangiomas can occur in various parts of the body, particularly on exposed areas of 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 very rare cases, they may transform into malignancy, even posing a life-threatening risk.
In traditional Chinese medicine, hemangiomas are believed to be caused by internal heat toxicity, uncontrolled heart fire, abnormal blood circulation, 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 fire, and nourish yin.
Early treatment is recommended for hemangiomas, with better efficacy and prognosis the earlier it is treated.
Related Information
1. Aesthetic Impact: Superficial hemangiomas can occur on various parts of the body, most commonly on the face, neck, torso, and limbs. Due to their red, black, or bluish-purple color, irregular or convex shapes, or dilated and winding patterns, they severely affect aesthetics, causing significant physical and psychological harm to patients.
2. Severe Bleeding: Hemangiomas can cause severe bleeding due to external impact or compression, leading to uncontrolled blood flow.
3. Tissue Damage and Deformity: They can damage surrounding tissues, causing deformities and impairing function.
4. Abnormal Skeletal Development: Hemangiomas can affect skeletal growth and development.
5. Ulceration: The tumor may develop ulcers.
6. Severe Limb Deformity: Hemangiomas can cause severe limb deformities.
7. Genetic Transmission: They can be inherited by offspring.
Intravascular Hemangiomas
Hepatic hemangiomas are actually congenital developmental abnormalities caused by the proliferation of hepatic vascular endothelial cells or secondary vascular expansion. They are the most common benign tumors of the liver. Based on the amount of fibrous tissue, they can be classified as (sclerosing hemangiomas), (angioendothelioma), (angiofibroma), capillary hemangiomas, and cavernous hemangiomas, with the latter being the most common.
This condition is more common in females and can occur at any age, either as a solitary or multiple lesion, 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:
1. As the tumor grows or compresses the stomach and intestines, it may cause upper abdominal discomfort, bloating, pain, and nausea. In severe cases, it can lead to deformation and functional impairment of normal organs such as the stomach and spleen.
2. A large hemangioma on the liver surface may rupture spontaneously, causing severe abdominal bleeding and life-threatening complications.
3. It can transform into a malignant hemangioma.
4. Liver area pain and psychological stress.