Cliniques universitaires Saint-Luc

Cliniques universitaires Saint-Luc

Centre for vascular anomalies

Vascular tumors

Hemangioma

Hemangioma is the most common benign vascular tumor of infancy with a 10-12% incidence at 1 year of age. It usually appears a few weeks after birth, grows very rapidly until 10-12 months of age (proliferative) and spontaneously involutes within 5-10 years.

Figure 1: Natural evolution of hemangioma
Age 3 month;
proliferating hemangioma on the right cheek
Age 5 years;
note the nice involution of this hemangioma
(Copyright 1999 L.M. Boon)

Therefore, most hemangiomas do not need any treatment but a rigourous clinical follow-up. However, during the proliferative phase, hemangioma can cause deformation or ulceration, bleeding or even obstruction of vital organs. Pharmacologic therapies (local/systemic corticosteroid or interferon a-2a) will be the treatment of choice of proliferating hemangiomas

Figure 2: Successful treatment with systemic corticosteroid
3-month-old girl with proliferating hemangioma
on the upper eyelid causing amblyopia.
Result after 5,5 months of systemic corticotherapy;
note the nice involution of the hemangioma at 2 years of age.
(Copyright 1999 L.M. Boon)

Surgical resection is also sometimes mandatory.

Figure 3: Surgical resection of involuted hemangioma
One-year-old girl
with proliferated hemangioma.
Two years after surgical resection
performed at age 3 years.
(Copyright 1999 L.M. Boon)

Kaposiform hemangioendothelioma

Kaposiform hemangioendothelioma is another rare but life-threatening vascular tumor that can be seen in children. This vascular tumor has the particularity to trap platelets so that the child is left with a very low platelet count (less than 40 000/ mm3). Treatment is very difficult. Several drugs have been used with various success rate (corticosteroid, interferon a-2a, chemotherapy), as well as radiotherapy in some instances.

Figure 4
6-month-old boy with hemangioendothelioma complicated
with Kasabach-Merritt phenomenon (platelets count: 8000/mm3).
(Copyright 1999 L.M. Boon)