Hemangiomas: An Overview

Abstract

Hemangiomas are the most common tumors of infancy 2 and are also the most common tumors of the head and neck in infancy. 3 The incidence of hemangiomas in the first 3 days of life is 1.1% to 2.6% 4,5 and increases to 8.7% to 12.7% between the ages of 1 month and 1 year of life. [6][7][8] Amir et al 8 found that the incidence of hemangiomas increased with prematurity. In infants with birth weights of less than 1500 grams, the incidence of hemangiomas was 15.6%, and as the birth weight decreased below 1000 grams, the incidence of hemangiomas increased to 22.9%. Holmdahl 9 did not observe any difference in the incidence of hemangiomas between premature and mature infants; however, a review of his study shows that the birth weights of the infants were much greater than those of Amir et al. 8 A review of 830 patients examined by a single pediatric dermatologist during a 3-month period found vascular lesions to be the most common, with 44% of infants having these lesions. 10 Hemangiomas are more frequent in girls than boys, ranging from a 3:1 to 5:1 ratio. [11][12][13] They are thought to be more common in white patients than in blacks; however, Pratt 4 noted an 1% incidence of hemangiomas in black infants. Most series show an increased incidence of hemangiomas in the head and neck region, followed by the trunk and then the extremities. 12,14 The incidence of hemangiomas in infants whose mothers underwent chorionic villus sampling is 10 times greater than those infants whose mothers did not undergo the procedure. 15 Approximately 20% of infants will present with more than 1 lesion. 16 Most hemangiomas occur sporadically; however, a family history of hemangioma has been noted to be present in up to 10% of patients with hemangiomas. 12 Recently, Blei et al 17 were able to identify 6 families that demonstrated autosomal dominant transmission with moderate-to-high penetrance of hemangiomas. The female-male ratio was 2:1,

Expression of CD34 and CD105 as markers for angiogenesis in oral vascular malformations and pyogenic granulomas

“…These results regarding CD105 immunostaining also suggest that, based on the assumption that this antibody is only expressed on newly formed vessels, tumor specimens [14]. Thus, in this series 50% of oral VMs were in the non-proliferative phase and 80% of OPGs were in the phase of development or endothelial proliferation, a fact emphasizing the importance of angiogenic mechanisms for the etiopathogenesis of these tumors [15].…”

“…These results support the view that angiogenesis is an important process in the growth and development of different head and neck tumors. However, these findings do not emphasize only the similarity between oral VMs and PGs and the relevance of CD105 and CD34 immunostaining for the study of vascular neoformations, but also the tendency to consider that angiogenic factors play an important role in the pathogenesis of these tumors reported in several investigations [12,14,15]. However, the exact role of the angiogenesis and its relationship with the development of many tumors still needs to be clarified so that it can be used as a safe tool for the identification of the biological potential of the tumor and as a coadjuvant in available treatments.…”

Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

“…Sclerotic therapy may be achieved by intralesional injections of corticosteroids, use of interferon, or by laser therapy, cryosurgery or radiations (22). Surgical excision and sclerotherapy are most commonly used in clinical practice.…”

“…Some studies have indicated a risk of pulmonary fibrosis in patients receiving more than 160 mg of bleomycin systemically (31). It is reported that the total dose must not exceed 5 mg/kg, or approximately 20 mg in total, for this to occur in infants (22).…”

Imaging findings of vascular lesions in the head and neck

“…Hemangioma is the most common vascular neoplasm of the head and neck and may be seen in various localizations (3,4). The ISSVA classification system divides hemangiomas into two types: infantile hemangiomas and congenital hemangiomas.…”