Hemangiom

Hemangiom is a benign vascular tumor characterized by proliferation of blood vessels. The term most often refers to infantile hemangioma, a common tumor of infancy that typically appears weeks after birth, enlarges during the first months, and then involutes gradually over several years. Congenital hemangiomas are present at birth and may involute rapidly (rapidly involuting congenital hemangioma) or persist (non-involuting congenital hemangioma). Hemangiomas can be capillary (small vessels) or cavernous (larger vascular spaces) and may involve skin, subcutaneous tissue, mucosa, or, less commonly, visceral organs such as the liver. Infantile hemangiomas are usually GLUT1-positive, a histologic marker that helps distinguish them from other vascular lesions.

Clinical features include cutaneous lesions that are typically red or skin-colored nodules or plaques that grow in the first year of life and then involute over time; many resolve with limited residual changes by childhood. Internal (visceral) hemangiomas may be asymptomatic but can cause symptoms or complications depending on location, such as mass effect or bleeding if ulcerated.

Diagnosis is mainly clinical. Imaging with ultrasound Doppler can assess extent and blood flow; MRI or CT may be used for deep or visceral lesions. Biopsy with GLUT1 staining can aid diagnosis when tissue is obtained.

Treatment ranges from observation to active therapy. Uncomplicated, non-disfiguring lesions are often watched. Systemic propranolol is first-line therapy for significant lesions; alternatives include topical timolol, intralesional steroids, laser therapy, or surgical excision for residual deformities. The prognosis is generally excellent, as most infantile hemangiomas involute over time. Epidemiology: more common in female infants and associated with prematurity and multiple births.