Reviewed By: Pramod Kerkar, MD, FFARCSI

What is Atypical Hemangioma?

A hemangioma is a benign tumor that is produced by the accumulation and proliferation of blood vessels in the skin or in an organ. This lesion develops in the cell layer, called the endothelium, of all blood vessels, including the smallest capillaries.

In any part of the body where blood vessels are found, a hemangioma may appear: in different internal organs (for example, liver, kidneys, brain, spleen or lungs), and also in the bones. It often appears in the first days or the first weeks of life. Normally, it remits by itself in the first five years. There are two types of hemangioma: capillary and cavernous.

Capillary Hemangioma

A capillary hemangioma is formed by the accumulation of small blood vessels with a small internal diameter. This lesion appears, mainly, in the skin or in the mucosa. About half of this type of hemangiomas is manifested in the neck and head area. Red in appearance due to the accumulation of a multitude of blood vessels, the diameter of a hemangioma can measure between 0.2 and 2 centimeters.

Cavernous Hemangioma

Cavernous hemangiomas refer to those that affect the deepest blood vessels (deep dermis and hypodermis). Normally they acquire a color between bluish and violaceous and they are, mainly, in the skin of the face or in the trunk. The cavernous hemangioma usually receives the name of nevus in flame (naevus flammeus).

Hemangiomatosis

Hemangiomatosis refers to the presence of several hemangiomas at the same time.

It usually appears as a consequence of an embryonic malformation and is associated with other deformities related to systemic diseases. To these types of diseases belong the following:

-Sturge-Weber Syndrome. It is identified by hemangiomas in the meninges and on the face, as well as by mutations in the eyes.

-Hippel-Lindau Syndrome. In this case, hemangiomas appear in the retina and cerebellum, as well as cystic mutations in internal organs.

-Klippel-Trenaunay Syndrome. Hemangiomas appear especially in arms or legs. The injuries can get very big.

The causes of hemangioma are unknown. Hemangiomas are abnormalities of the blood vessels that multiply by triggers that are not clear.

However, there are hereditary conditions that could explain certain hemangiomas.

If a hemangioma appears throughout the body, it is thought that congenital factors intervene, just as in the predisposition to form them.

The diagnosis of a hemangioma is usually made based on the signs. In the skin hemangioma, the reddish and bluish colorations that appear in the affected area are visible.
The size of these spots differs a lot, can be a few millimeters or grow up to several centimeters. An example is the flame nevus.

In the case of hemangiomas in internal organs, most are detected by chance during medical examinations that seek the origin of other diseases. Thus, the liver hemangioma is usually detected following an ultrasound or computed tomography (CT) of the abdomen.

The hemangioma has its own evolution and usually disappears on its own. The evolution of a hemangioma can be divided into three phases:

Proliferation Phase. lasts from 6 to 9 months, it rarely lasts long.

-Inactivity Phase. Of different durations.

-Regression Phase. The duration depends on the size of the hemangioma and the affected areas, most of the time it has been completed before the age of nine.

Complications

Normally, a hemangioma does not produce complications because it usually does not grow or, if it does, it is slow. If the hemangioma develops rapidly, it can become annoying for the patient and have aesthetic conditions.

They can also spread rapidly through more critical areas due to their situation (for example, armpits or genital region), where they can create functional limitations and lead to skin damage. In these areas, the risk of bleeding, pain and subsequent infections is higher.

Conclusion

Hemangiomas own the aforementioned characteristics and the differences can be evident in an imaging test, such as an ultrasound.

There are forms of atypical presentation of hemangiomas. One of them is the pedunculated hemangioma, it is a very rare presentation and only 17 reported cases had been registered in the world literature up to this day.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 22, 2018

This article does not provide medical advice. See disclaimer

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