Reviewed By: Pramod Kerkar, MD, FFARCSI

Strawberry hemangioma also known as simplex hemangioma is a common occurrence in infants and they are non-cancerous. It is a benign tumor made up of blood vessels. Hemangioma may appear anywhere in the body, but the most prominent location of hemangioma is neck, face and scalp. It may not be visible at the time of birth, but may starts developing within 1 to 2 months of birth. Although hemangioma is non-cancerous, but sometime complications may arise due to ulceration, bleeding or infection in the hemangioma. Sometimes complications may arise due to the location of hemangioma such as pulmonary hemangioma or ocular hemangioma.

What Causes Strawberry Hemangiomas?

Strawberry hemangioma is generally seen in the patients who are born before the due date of delivery. There is an initial proliferative phase of growth in which the hemangioma rapidly grows for few weeks. After that there is an involution phase resulting in resolution. There might be a mass that is left after the involution stage.

Although, there is no need to worry about hemangiomas as they are not the malign tumor, but sometimes complications do exist. The complication may include ulceration and risk of infection if the hemangioma is ruptured and the complication also depends upon the localization of hemangioma. If the hemangioma is present in lungs, the breathing may be severely affected. Further, in case of peritoneal hemangioma, there are risks of infection and bleeding.

The cause of strawberry hemangioma is not exactly known, rather there are certain processes deemed to be responsible for the formation of hemangioma.

  1. Placental Origin: One theory suggests that the strawberry hemangioma develops from the placenta. This theory is evidenced by the fact that the histochemical markers that are present in the strawberry hemangioma are also present on the placental blood vessels. There is a consistency in the genetic make-up of the placental cells and the cells of hemangioma. The evidence for this theory is very strong and the strawberry hemangioma may have developed from the placenta.
  2. Hypoxia Condition: It has also been postulated that hypoxia in the placental region also triggers the inappropriate proliferation of endothelial progenitor cells. When the tissue becomes hypoxic, there may be an attempt to maintain the homeostasis of the hypoxic tissue and it is when the strawberry hemangioma proliferation takes place. The hypoxia theory is also backed up by various evidences. Whenever there is a hypoxia in fetus, there will be a low birth weight which is considered as an important risk factor in hemangioma. Further, in hemangioma infants there is a tendency of retinopathy which is also an outcome of hypoxia.
  3. Existence of Certain Types of Cells: It has also been stated that there are certain cells which are present in the fetus during the advanced stages of development. These cells may also initiate the formation of strawberry hemangioma. Endothelial cells, that form the inner lining of the vessel wall and the mural cells forms the surface of the vessel wall.
  4. Hemangioma developed by Angiogenic Peptides: It has also been postulated that there are certain angiogenic peptides that are responsible for the development of strawberry hemangioma.

There are certain other theories which also hypothesize the development of strawberry hemangioma. However, the exact cause of this disease is yet to be known with confirmatory evidence.

Conclusion

Hemangioma is the tumor of blood vessels usually developed on the face, neck and scalp. It is non-cancerous and generally free of complications. But sometimes the complications may arise, which may be life threatening. The exact cause of the development of hemangioma is unknown, but there are certain theories postulated on the basis of evidence studied by the researchers. One theory postulate that the hemangioma is developed from placenta as it has similar profile as placenta. The other theory postulates that are developed due to hypoxic condition in the fetus and to counter the hypoxic effect on the tissue, cellular proliferation takes place that result in to hemangioma. These two theories are said to be strongest for the quality of evidence they are standing upon.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 24, 2018

This article does not provide medical advice. See disclaimer

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