Hemangioma: Specialists & Information

The 1996 classification by the “International Society for the Study of Vascular Anomalies” (ISSVA) serves as the basis for this distinction. According to this classification, physicians distinguish between the following vascular anomalies:

• hemangiomas and
• vascular malformations.

Accurate diagnosis can only be achieved through interdisciplinary collaboration. The diagnosis is followed by an individualized treatment plan.

Definition: Hemangioma

Hemangiomas are the most common tumors in childhood. They appear immediately after birth or in the first few weeks of life and are generally benign.

A hemangioma originates from the endothelium (the innermost layer of cells in a blood vessel). It is avascular tumor characterized by proliferating (i.e., rapidly growing) new tissue formations.

Hemangiomas are characterized by

• rapid growth (6 to 12 months),
• a phase of stagnation (6 to 12 months), and
• a phase of regression (1 to 12 years).

In 90 percent of cases, hemangiomas regress spontaneously.

Hemangiomas can grow very large, but they often regress spontaneously © Any Grant | AdobeStock

Definition: Vascular Malformations

Vascular malformations are hereditary. They are abnormalities characterized by dysplastic (malformed) blood vessels without cellular proliferation (rapid cell growth).

They do not undergo spontaneous regression (spontaneous healing). They often do not become apparent until childhood or adolescence. Vascular malformations grow in proportion to the child’s development.

Growth spurts in vascular malformations can be triggered by

• hormonal changes during puberty or pregnancy,
• trauma, or
• surgical procedures

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Vascular malformations are classified according to the characteristics of blood flow in the blood vessels as follows:

• Slow blood flow (“low flow”): capillary malformation, lymphatic malformation, venous malformation
• Rapid blood flow (“high flow”): Arteriovenous malformation

Hemangiomas are associated with the following symptoms:

• Warm swellings,
• berry-like protrusions,
• infiltrating space-occupying lesions with overlying normal skin,
• functional and cosmetic impairments.

Careful diagnosis is necessary to distinguish between hemangiomas and vascular malformations. It begins with a thorough review of the patient’s medical history and clinical findings.

Additional tests include

• color-code duplex sonography (ultrasound examination of blood flow),
• an MRI (magnetic resonance imaging to assess depth),
• time-resolved MR angiography (visualization of blood vessels using various imaging techniques in cases of vascular malformations), as well as
• X-rays or CT scans (in cases of bone changes).

The following treatment methods are used for hemangiomas:

• Follow-up monitoring,
• cryosurgery (for superficial and small hemangiomas),
• Laser surgery (for larger lesions),
• flash-lamp-pumped dye lasers or IPL (penetration depth 2 mm),
• percutaneous use of a neodymium:YAG laser,
• systemic therapy with corticosteroids or beta-blockers (to promote regression of hemangiomas), as well as
• surgical removal of hemangiomas in critical areas.