What is a hemangioma?

Hemangioma is a benign tumor occurring at birth. It is a bundle of blood vessels, typically on the skin, but it can also be in internal organs. They are separated into two categories, infantile or congenital. Infantile hemangiomas are the most common, growing quickly for the first six months of life. After pausing growth at about six to 10 months, the hemangioma involutes (shrinks) at about a year. Infantile hemangiomas occur in approximately one in 10 children and are the most common vascular anomaly treated at the Vascular Anomalies Center of Excellence. Congenital hemangioma is its maximal size at birth. It may go away quickly, take time to go away or never go away.

Your care team at Arkansas Children’s is experienced in treating hemangiomas, and will work with you to create the best treatment plan for your child.

Infantile hemangiomas are tumors containing small abnormal blood capillaries that resemble placental tissue. They then grow intermittently, and sometimes quite rapidly, throughout the first 10 -12 months of life. There is usually no more growth after a year of age, and the hemangioma starts its involutional phase. In this phase, the hemangioma can shrink and lighten in color, or it may not appear to do anything. 

Infantile hemangiomas can be classified by the areas they involve. Superficial hemangiomas involve skin only.

  • Deep hemangiomas involve the layers of tissue below the skin and can vary in color from deep purple/blue to skin tones if they are really deep.
  • Compound hemangiomas involve both the skin and deeper tissues.
  • They are vascular birthmarks that usually appear within the first few weeks of birth. Some may even be seen as a small red mark or bruise at birth.

How are infantile hemangiomas treated?

Depending on the size of the hemangioma, this shrinking is frequently not enough to make the lesion “go away.” A large percentage of hemangiomas will require some form of intervention to correct the deformity caused by the growth of the hemangioma or to correct scarring caused by ulceration. Treatment options include medical therapy with Propranolol, beta-blocker therapy, a topical treatment known as Timolol, laser therapy or surgical removal.

Congenital hemangiomas are fully formed at birth, and they usually don’t grow anymore, but they may or may not involute (shrink). There are two types of congenital hemangioma:

  • RICH (rapidly involuting congenital hemangioma)
  • NICH (non-involuting congenital hemangioma)

Like each of their names implies, one tends to go away rapidly, and the other doesn’t change at all.

Still, surgical removal is required the hemangioma does not shrink on their own.

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