They are one of the most commonly found benign tumors in children. The word comes from the Greek term haema that means blood, angeio that means vessels and oma that stands for tumor. This is because it is a swelling or growth of the endothelial cells that line the blood vessels. These tumors are commonly seen as birthmarks in newborn babies. In many cases, these lesions develop after a few weeks to months after birth of the infant. Many parents are often asked to wait and allow the hemangioma in babies to 'go away' on its own. However, these tumors may increase in size and lead to many complications. In such cases, treatment becomes necessary to help the child live a normal life.
Infantile hemangioma, also called 'strawberry mark', are an abnormal cluster of small veins that combine and get dilated. They commonly occur on the face and neck, but may also be present on other parts of the body. They may be seen on the liver, spine, etc. They appear like a small bruise or a red bump. Gradually they begin to grow and develop a change in appearance.
There are two types of hemangiomas: superficial and compound. In case of superficial lesions, they appear flat and involve only the upper skin layers. The compound hemangiomas occur deep within the skin and appear as a large lump. The color of these tumors maybe purple, bright red or even normal skin color. They are as small as 1 mm and can grow more than 20 cm in size.
The cause is still a mystery. Studies have found that females are more prone to this disorder than males. It may be due to the female hormone estrogen thought to promote the formation and growth of these benign lesions. They tend to grow and resolve on their own without treatment. However, when they involve vital organs like the eye, wind pipe, ears, etc. which may begin to bleed, get infected or lead to deformity of the surrounding tissue due to rapid growth, it becomes necessary to treat the condition.
Many parents are advised to leave hemangioma alone and wait for it to 'go away'. This is all right as most of the lesions disappear by the time the child is 10 years of age. There are different factors that play a role when it comes to treating lesions. If the lesion is proliferating and enfolding, compound, or located near a vital organ, one may have to choose a suitable treatment option.
When it comes to treating hemangiomas, the first thing doctors do is observe the patient for a period of time. This will give the doctors time to find out how much does the lesion change with time. In case of very young infants who are one to two months old, it gives them time to gain weight and respond to treatment. Observation period helps the doctors to know if the growth is slow and gradual or rapid, leading to dramatic changes. Once they know and understand the proliferation and nature of the lesion, treatment options for hemangioma in infants are considered. Let us have a look at the different treatment options available.
Use of Steroids
Steroids form the most important part of treating them. They help in slowing down the proliferation of the lesions. However, steroids are not recommended for involution of hemangioma. Systemic or oral steroids are given to the patient to slow down the growth of a lesion in a cosmetically sensitive area. However, steroids may have short-term side effects and have to be closely monitored. These side effects include systemic infection, high blood pressure, growth retardation, immunosuppression, gastrointestinal upsets, etc. The corticosteroid treatment may last for about a few weeks to many months. Most of the time, the corticosteroids are directly injected into the hemangioma, if it is small, localized or cutaneous.
Use of Lasers
Laser treatment helps in removing the hemangiomas completely and treating the broken blood vessels. One may have to undertake multiple laser treatments depending on the size, location and age of the patient. The flashlamp pulsed dye laser is generally used for superficial hemangiomas. However, it does not have the needed effect on thicker and deeper hemangiomas. Laser treatment is generally used to treat ulcerated hemangioma, broken blood vessels (telangiectasia) and promote healing.
Many patients need surgery to remove hemangioma completely. The surgical treatment option is needed when the tissues obstruct body function or turn life-threatening. It is also required to reconstruct scars and for cosmetic treatment. One has to consider all the pros and cons of surgery before deciding on carrying out an operation. Many times, children over the age of 4 are considered for surgical treatment.
Use of Medications
There are certain medications that help in treatment of tumors. These medications include Vincristine that is given in form of an injection into the central venous line once a week. It is used in cases where the lesions obstructs the patient's vision or compromises the airway path. Propranol is another medication that helps in treating the same. It has to be closely monitored as it may lead to a drop in blood sugar level, blood pressure and heart rate in children. This medication is given orally 2 to 3 times a day. Ulceration on the hemangioma can be treated using Becaplermin gel. It is very expensive and one may need to get a special letter from the doctor for insurance assistance on this gel.
This was some information regarding treatment options in infants. These tend to develop very quickly during the proliferation stage. This stage lasts for about 12 months after which comes the rest stage. During this time, there is very little change in the appearance of the same. Then comes the involution phase where the hemangioma begins to shrink in size. In about 50% of the cases, the lesion disappears by the age of 5 years and most of the cases by 10 years of age. However, if the hemangioma grows in size leading to complications and cosmetic issues, treatment options are considered.
This was all about the options for treating hemangioma. Hope the above information was useful to you in understanding the cure for hemangiomas. For further details, don't hesitate to speak to your doctor who can provide you with more information and help.