Vascular Tumors
| Figure 2.16
A: Hemangioma
(Courtesy of Dr. Michelle
B. Bain)
B: Tufted angioma
C: Pyogenic granuloma |
- More common in premature infants, 15% have multiple lesions with higher risk for visceral involvement, GLUT1 positive (endothelial marker, useful in differentiating from malformation)
- Precursor lesion: pink or bruised macule or patch with surrounding telangiectasias
- Superficial hemangioma (strawberry hemangioma) situated in the superficial dermis and bright red in color during the proliferative phase
- Deep or cavernous hemangioma (located deep dermis and/or subcutis) presents as blue-purple mass with normal overlying skin, ± bruit
- Involution: 30% by age 3, 50% by age 5, 70% by age 7, 90% by age 9
- Complications: ulceration (most common), anatomic distortion with interference of normal function, high-output congestive heart failure (greater risk with visceral hemangiomas, especially if in liver)
- Regionally significant hemangiomas: periocular (obstruct vision and cause ophthalmologic complications), beard region (clue for laryngeal hemangiomatosis with airway obstruction), segmental hemangioma over lumbosacral area (MRI of spine to r/o GU/GI/spinal/skeletal abnormalities), nasal tip (textural changes and scarring)
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