Hemangioma, Pediatric
A hemangioma is a noncancerous (benign) tumor that is made up of blood vessels. A hemangioma may be present at birth or may appear in the weeks or months after birth (infantile hemangioma). In most cases, the child will have a single tumor, but there can be more than one. Depending on the size and location of the hemangioma, it may interfere with your child's ability to see, breathe, eat, or pass urine.
There are several types of hemangiomas. A hemangioma may:
Form on the surface of the skin (superficial hemangioma). This type is bright red and may look like a strawberry.
Develop under the skin (deep hemangioma). This type may feel like a rubbery lump and may be blue or gray.
Be both deep and superficial (combined hemangioma).
Form inside the body and involve internal organs (extracutaneous hemangioma).
Infantile hemangiomas usually go through a period of rapid growth in the first weeks after the child is born. They may continue to grow until the child is a year old. They may start to shrink after age 1 and continue to shrink until age 10.
What are the causes?
Infantile hemangiomas are formed by cells that normally line the blood vessels. The reason why these cells develop into a hemangioma is not known.
What increases the risk?
This condition is more likely to develop in children who:
What are the signs or symptoms?
Symptoms of this condition depend on the type of hemangioma. Common signs and symptoms include:
A red, raised growth that looks like a strawberry.
A lumpy, gray or blue growth.
A break in the skin that oozes or bleeds (ulceration).
Pain, especially with ulceration.
How is this diagnosed?
This condition may be diagnosed based on a physical exam. Your child may also have tests, including:
Imaging studies, such as an ultrasoundor MRI. These show how deep the hemangioma is and whether it affects another structure in the body.
A procedure to remove a piece of the tumor for testing (biopsy). This is done to make sure that the growth is not cancerous.
How is this treated?
In most cases, treatment is not needed for this condition. Most hemangiomas shrink and go away on their own over time. Medical treatment may be needed if the tumor is interfering with your child's vision, is ulcerating and causing pain, or is growing very quickly. Treatment depends on your child's age as well as the type, location, and growth of the tumor. Possible treatments include:
- Medicines, such as:
A medicine called propranolol. This is usually the first choice for medical treatment. It can be given by mouth as a liquid.
Medicines placed on the skin (topical) to treat small hemangiomas.
Steroid medicines taken by mouth, applied to the skin, or injected into a hemangioma.
Wound care, antibiotic medicines, and bandages (dressings) for an ulcerated hemangioma.
Laser treatment. This may be done if a superficial hemangioma is close to an important skin area, such as the eye or the mouth. Laser treatment may also be used for a superficial hemangioma that ulcerates.
Surgery. This may be used in certain cases if other treatments have not worked. Surgery may be needed for a life-threatening hemangioma or to save vision, open the airway, or remove a very disfiguring growth.
Follow these instructions at home:
Medicines
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Give over-the-counter and prescription medicines only as told by your child's health care provider.
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If your child was prescribed an antibiotic medicine, give it as told by the health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
If your child has an ulcerated hemangioma:
- Follow instructions from the health care provider about how to take care of your child's wound. Make sure you:
Wash your hands with soap and water for 20 seconds before and after you clean the wound or change your child's dressing. If soap and water are not available, use hand sanitizer.
Clean the wound 2–3 times a day, or as told by the health care provider. To do this, wash the wound with mild soap and water, rinse off the soap, and pat the wound dry with a clean towel. Do not rub the wound.
Change your child's dressing as told by the health care provider.
Keep the dressing clean and dry.
- Check your child's wound every day for signs of infection. Check for:
General instructions
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Have your child return to his or her normal activities as told by his or her health care provider. Ask your child's health care provider what activities are safe for your child.
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Keep all follow-up visits. This is important.
Contact a health care provider if your child:
- Has any signs of infection in an ulcerated hemangioma, such as:
- Has a hemangioma that does any of these:
Starts to grow or spread suddenly.
Ulcerates.
Interferes with your child's ability to see, eat, or urinate.
These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).
Summary
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A hemangioma is a noncancerous (benign) tumor that is made up of blood vessels.
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In most cases, treatment is not needed for this condition. Most hemangiomas shrink and go away on their own over time.
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Medical treatment may be needed if the tumor is interfering with your child's vision, is ulcerating and causing pain, or is growing very quickly.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
