Hemangioma

Medically reviewed by Xixi Luo, MD on July 20, 2017Written by April Kahn

Hemangioma

What is a hemangioma?

Hemangiomas, or infantile hemangiomas, are noncancerous growths of blood vessels. They’re the most common growths or tumors in children. They usually grow for a period of time and then subside without treatment.

They don’t cause problems in most infants. However, some hemangiomas may open and bleed or ulcerate. This may be painful. Depending on their size and location, they may be disfiguring. Additionally, they may occur with other abnormalities of the central nervous system or spine.

The growths may also occur with other internal hemangiomas. These affect internal organs such as the liver, other parts of the gastrointestinal system, the brain, or organs of the respiratory system. The hemangiomas that affect organs usually don’t cause problems.

How do hemangiomas develop?

On the skin

Hemangiomas of the skin develop when there is an abnormal proliferation of blood vessels in one area of the body. Experts aren’t sure why blood vessels group together like this, but they believe it’s caused by certain proteins produced in the placenta during gestation (the time when you’re in the womb).

Hemangiomas of the skin can form on the top layer of skin or on the fatty layer underneath, called the subcutaneous layer. At first, a hemangioma may appear to be a red birthmark on the skin. Slowly, it will start to protrude upward from the skin.

On the liver

Hemangiomas of the liver form in and on the liver’s surface. These hemangiomas are thought to be sensitive to estrogen. During menopause, many women are prescribed replacement estrogen to minimize symptoms caused by the decline of their natural estrogen levels. This excess estrogen can spur the growth of liver hemangiomas. Similarly, pregnancy and sometimes oral contraceptive pills can increase the size of hemangiomas.

Where they occur

Besides the skin and liver, hemangiomas can grow on other areas within the body, such as the:

Hemangiomas that grow in the brain cavities or other cavities within the body are called cavernous hemangiomas.

Signs and symptoms of hemangiomas

Hemangiomas don’t normally cause symptoms during or after their formation. However, they may cause some symptoms if they grow large or in a sensitive area or if there are multiple hemangiomas.

Hemangiomas of the skin usually appear as small red scratches or bumps. As they grow, they look like burgundy-colored birthmarks. Skin hemangiomas are sometimes called strawberry hemangiomas because of their deep red appearance. This type mostly occurs on the neck or face.

In the internal organs

Hemangiomas inside the body usually go unnoticed until they grow large or until multiple hemangiomas form. Some symptoms that indicate you might have an internal hemangioma include:

How they’re diagnosed

No special tests are used to diagnose skin hemangiomas. Your doctor can make a visual diagnosis during a physical examination.

Hemangiomas on the organs are usually spotted during an imaging test, such as an ultrasound, MRI, or CT scan. They’re usually detected as an incidental finding.

Treatment options for hemangiomas

A single, small hemangioma usually requires no treatment. It will likely go away on its own. However, some cases require treatment, such as skin hemangiomas that develop lesions or sores.

Treatment options include:

Corticosteroid medication: Corticosteroids may be injected into the hemangioma to reduce its growth and to stop inflammation.

Beta-blockers: Topical beta-blockers, such as timolol gel, can be used several times per day for 6 to 12 months for small, superficial hemangiomas. They may also have a role in treating smaller ulcerated hemangiomas. This medication is generally considered safe.

Laser treatment: Laser treatment is used to remove the hemangioma. In some cases, a surgeon may use laser treatment to reduce redness and promote faster healing.

Medicated gel: A medicated gel called becaplermin (Regranex) is often used to treat ulcers on the surface of skin hemangiomas. This gel has no effect on the hemangioma itself. It’s also used as a second-line treatment when other treatments have failed. It carries a risk of death from cancer in people who receive it repeatedly. Talk to your doctor about the risks.

Surgery: If the hemangioma is large or in a sensitive area, such as the eye, your doctor may opt to remove it surgically.

For hemangiomas on the organs

Hemangiomas within the body may require treatment if they grow too large or cause pain. Treatment options for these hemangiomas include:

  • surgical removal of the hemangioma
  • surgical removal of the damaged organ or damaged area
  • tying off of the main artery that supplies blood to the hemangiomas

Outlook

More often than not, a hemangioma is more of a cosmetic concern than a medical one. Still, you should talk to a doctor if you have any concerns or want to discuss removal.

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