Current management of hemangiomas and vascular malformations
Section snippets
Pathogenesis
Hemangiomas are endothelial tumors with a unique biologic behavior—they grow rapidly, regress slowly, and never recur. The three stages in the life cycle of a hemangioma, each characterized by a unique assemblage of biologic markers and processes, are (1) the proliferating phase (0–1 year of age), (2) the involuting phase (1–5 years of age), and (3) the involuted phase (>5 years of age). These stages are typically clinically apparent and can be distinguished microscopically and
Classification
Vascular malformations result from errors of embryonic and fetal development. The classification of these anomalies is based on the clinical, radiologic, and histologic appearance of the abnormal channels, which may be either hematic or lymphatic in nature. A vascular malformation can be slow-flow (ie, capillary, lymphatic, or venous) or fast-flow (ie, arterial). If there are combinations of these elements, the malformation is called an arteriovenous malformation (AVM), lymphatico-venous
Summary
Patients with vascular anomalies were previously outcasts in the medical system. The internet has facilitated patient family communication and the advent of far-reaching support groups. With the advent of multidisciplinary clinics, physicians have found new ways to combine therapies for these complex patients. The plastic surgeon plays an essential role in defining this care.
References (43)
- et al.
Congenital hemangioma: evidence of accelerated involution
J Pediatr
(1996) - et al.
Congenital fibrosarcoma masquerading as congenital hemangioma: report of two cases
J Pediatr Surg
(1995) - et al.
Increased risk of symptomatic hemangiomas of the airway in association with cutaneous hemangiomas in a “beard” distribution
J Pediatr
(1997) - et al.
Spastic diplegia as a complication of interferon alfa-2a treatment of hemangiomas of infancy
J Pediatr
(1998) - et al.
Treatment of cutaneous hemangiomas by the flashlamp-pumped pulsed dye laser: prospective analysis
J Pediatr
(1992) - et al.
Randomised controlled study of early pulsed dye laser treatment of uncomplicated childhood haemangiomas: results of a 1-year analysis
Lancet
(2002) - et al.
Prenatal diagnosis of vascular anomalies
J Pediatr Surg
(2002) - et al.
Cystic hygroma in children: report of 126 cases
J Pediatr Surg
(1974) - et al.
Injection of bleomycin as a primary therapy of cystic lymphangioma
J Pediatr Surg
(1992) - et al.
Treatment of lymphangiomas in children: an update of Picibanil (OK-432) sclerotherapy
Otolaryngol Head Neck Surg
(1999)
Vascular malformations of the upper limb: a review of 270 patients
J Hand Surg [Am]
Hemangiomas and vascular malformations in infants and children: A classification based on endothelial characteristics
Plast Reconstr Surg
Congenital vascular lesions: clinical application of a new classification
J Pediatr Surg
Cellular markers that distinguish the phases of hemangioma during infancy and childhood
J Clin Invest
Cellular hemangiomas (hemangioendotheliomaS) in infants. Light microscopic, immunohistochemical, and ultrastructural observations
Am J Surg Pathol
Strawberry hemangioma in preterm infants
Pediatr Dermatol
Vascular birthmarks: hemangiomas and malformations
Non-involuting hemangioma: a rare cutaneous vascular anomaly
Plast Recon Surg
Not all hemangiomas look like strawberries: uncommon presentations of the most common tumor of infancy
Pediatr Dermatol
Cerebral vasculopathy and neurologic sequelae in infants with cervicofacial hemangioma: report of eight patients
Radiology
Cited by (226)
Vascular malformations and tumors of the hand: A therapeutical approach
2022, Journal of OrthopaedicsCitation Excerpt :This can often be combined with immunohistochemistry, for further differentiation between similar subtypes e.g. Congenital Hemangiomas are GLUT-1 positive, differentiating them from malformations.3,7,8 Given the slow growing behavior, in the majority of cases, watchful waiting is often indicated.8 Clinical follow up is essential, not only as a mainstay of therapy but, also after minimally invasive or surgical procedures.
Treatment of deep-seated palatal vascular malformations by bleomycin sclerotherapy
2021, Journal of Plastic, Reconstructive and Aesthetic SurgerySuccessful endovascular treatment of extra-intracranial arteriovenous malformation using a combination of liquid non-adhesive embolic agents
2021, Interdisciplinary Neurosurgery: Advanced Techniques and Case ManagementHead and neck venous malformations, a specialist centres experience of management and treatment outcomes
2021, Advances in Oral and Maxillofacial SurgeryADRENAL cystic lymphangioma PRESENTING as a nonfunctioning adrenal carcinoma in a 45-year-old male: Case report: Adrenal cystic lymphangioma in a 45-year-old male
2020, Journal of Clinical and Translational Endocrinology: Case ReportsA Curious Case of Multiple Lower Limb Swellings
2024, Indian Journal of Plastic Surgery