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Hemangioma

Definition

A hemangioma is an abnormal buildup of blood vessels in the skin or internal organs.

Alternative Names

Cavernous hemangioma; Strawberry nevus

Causes, incidence, and risk factors

About 30% of hemangiomas are present at birth. The rest appear in the first several months of life.

The hemangioma may be:

• In the top skin layers (capillary hemangioma)
• Deeper in the skin (cavernous hemangioma)
• A mixture of both

Symptoms

• A red to reddish-purple, raised sore (lesion) on the skin
• A massive, raised tumor with blood vessels

Most hemangiomas are on the face and neck.

Signs and tests

Hemangiomas are diagnosed by a physical examination. In the case of deep or mixed lesions, a CT or MRI scan may be performed.

Occasionally, a hemangioma may occur with other rare conditions. Additional tests may be done for these syndromes.

Treatment

Superficial or "strawberry" hemangiomas often are not treated. When they are allowed to disappear on their own, the result is usually normal-appearing skin. In some cases, a laser may be used to remove the small vessels.

Cavernous hemangiomas that involve the eyelid and block vision are generally treated with steroid injections or laser treatments. These quickly reduce the size of the lesions, allowing vision to develop normally. Large cavernous hemangiomas or mixed hemangiomas may be treated with oral steroids and injections of steroids directly into the hemangioma.

Recently, lasers have been used to reduce the size of the hemangiomas. Lasers that emit yellow light damage the vessels in the hemangioma without damaging the skin over it. Some physicians use a combination of steroid injection and laser therapy.

Support Groups

Expectations (prognosis)

Small, superficial hemangiomas often disappear on their own. About 50% go away by age 5, and 90% are gone by age 9.

Complications

• Bleeding (especially if the hemangioma is injured)
• Problems with breathing and eating
• Psychological problems, from skin appearance
• Secondary infections and sores
• Visible changes in the skin
• Vision problems (amblyopia, strabismus)

Calling your health care provider

All birthmarks, including hemangiomas, should be evaluated by the health care provider during a routine examination.

Hemangiomas of the eyelid may interfere with the development of normal vision and must be treated in the first few months of life. Hemangiomas that interfere with breathing, feeding, or other vital functions should also be treated early.

Prevention

There is no known way to prevent hemangiomas.

References

Habif TP. Vascular tumors and malformations. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 23.