Hemangiomas are benign (noncancerous) tumors. They are a type of vascular anomaly. There are two types of hemangiomas: infantile and congenital. Infantile hemangiomas grow after a child is born. Congenital hemangiomas are fully formed at birth and are rare.
Congenital hemangiomas may go away or may persist. Some hemangiomas may disappear without treatment. Fifty percent of infantile hemangiomas shrink by the time a child is 5 years old, 70 percent shrink by age 7 and 90 percent by age 10.
Hemangiomas can be found on any part of the body, but they most often appear on the neck and face. The location of a hemangioma can determine if your child is at risk for other conditions. Children with hemangiomas on the lower half of the face can be at risk for hemangiomas in the airway.
Although hemangiomas usually form on the skin, they can form on organs such as the liver, though this typically occurs when patients have a large number of hemangiomas on the skin. Externally, they appear as red marks that may be raised above the skin. In some cases, they can cause problems with excessive growth or interference with important functions.
Hemangiomas on the liver rarely cause symptoms. They may not be noticed until they grow large enough to be felt as a mass in the abdomen, result in cardiac (heart) problems or cause difficulty with feeding and gaining weight.
Syndromes Related to Hemangiomas
There are a number of syndromes related to hemangiomas, including:
- PHACE syndrome. PHACE is an acronym that stands for Posterior fossa, Hemangioma, Arterial lesions, Cardiac abnormalities/aortic coarctation and Eye abnormalities. PHACE syndrome is a condition in which infantile hemangiomas are related to malformations of the eyes, heart, major arteries and brain. Diagnosed in infancy, each child with PHACE syndrome has different needs and potential complications. For example, if your child has a hemangioma near the eye, vision development may be impacted. Children with PHACE syndrome can be at risk for neurological problems even after the hemangioma has shrunk. If your child is at risk for PHACE syndrome, his or her doctor will initiate a workup to make sure other organ systems are not involved.
- LUMBAR syndrome. LUMBAR is an acronym that stands for Lower body hemangioma and other cutaneous defects, Urogenital anomalies, Ulceration, Myelopathy, Bony deformities, Anorectal malformations, Arterial anomalies and Renal anomalies. LUMBAR syndrome occurs when patients have large hemangiomas in the groin area. They can cause problems with the spine, genitalia, urinary tract, anus and rectum. If your child is at risk for LUMBAR syndrome, his or her doctor will initiate a workup to make sure other organ systems are not involved.
Unrelated to infantile hemangiomas, kaposiform hemangioendothelioma (KHE) is a rare, noncancerous vascular tumor that can appear early in infancy. Complications include rapid growth of the tumor and blood clotting problems. KHE tumors may require aggressive therapy with medications such as sirolimus or steroids.
Diagnosis of Hemangiomas
Doctors at Riley at IU Health use the following exams and tests to diagnose hemangiomas:
- Physical exam. Your child's doctor will do a complete physical exam to assess your child’s overall health and check for the outward signs of hemangiomas.
- Ultrasound. An ultrasound creates images of body areas and organ systems so your child’s doctor can see how the hemangioma is affecting the body.
- Magnetic resonance imaging (MRI). The doctor may use MRI to obtain detailed images of your child’s head, neck and chest.
Treatments
Treatments
The main treatment options for hemangiomas are:
- Observation. Not all hemangiomas need immediate treatment. If it is not causing symptoms or damage, your child's doctor may recommend regular examinations for continued monitoring. As the anomaly develops, your child may eventually need treatment.
- Medicine. Beta blockers are the most common class of medications used to treat hemangiomas. A topical beta blocker can be used to treat smaller hemangiomas. Oral beta blockers are used for larger, more complicated hemangiomas. Steroids can also be used in particularly difficult cases, but this treatment is associated with additional side effects.
- Laser skin therapy. A pulsed dye laser can be used to treat the surface of a hemangioma that is bleeding or the persistent blood vessel that remains after a hemangioma regresses.
- Surgery. Some smaller, well-defined hemangiomas can be removed surgically if medication therapy is not successful.
Key Points to Remember
Key Points to Remember
- Hemangiomas are benign (noncancerous) tumors.
- There are two types: infantile (grow after birth) and congenital (fully formed at birth).
- Although infantile hemangiomas usually form on the skin, they can form on organs, too.
- Doctors diagnose hemangiomas through physical exam and imaging tests.
- Treatment options include regular observation by your child's doctor, medication, laser skin therapy and surgery.
Support Services & Resources
Support Services & Resources
Visit the trusted websites below to learn more about hemangiomas.
We offer a broad range of supportive services to make life better for families who choose us for their children's care.
The Hemangioma Investigator Group provides this educational website for parents of children with infantile hemangiomas.
This is a parent organization for patients with a complicated infantile hemangioma associated with PHACE syndrome.
Hemangiomas Research
Hemangiomas Research
Doctors in the Department of Dermatology at the Indiana University School of Medicine are active members of the Hemangioma Investigator Group. These doctors participate in several clinical studies for patients with infantile hemangiomas and PHACE syndrome.