Chapter 499 Benign Vascular Tumors
499.1 Hemangiomas
Hemangiomas, the most common benign tumors of infancy, occur in about 5% of term infants (Chapter 642). The risk of hemangioma is 3-5 times higher in girls than boys. The risk is doubled in premature infants and 10 times higher in offspring of women who had chorionic villus sampling. Hemangiomas can be present at birth but usually arise shortly after birth and grow rapidly during the 1st yr of life, with slowing of growth in the next 5 yr and involution by 10-15 yr of age.
Clinical Manifestations
More than 50% of all hemangiomas are located in the head and neck region. Most are solitary lesions, but the presence of more than one cutaneous lesion increases the likelihood of visceral hemangiomas. The liver is the primary site of visceral involvement; other involved organs include the brain, intestines, and lung. Most hemangiomas require no therapy, but approximately 10% of hemangiomas cause significant impairment and 1% are life-threatening because of their location. Hemangiomas around the airway can cause airway obstruction, and those around the eyes can result in loss of vision. Ulceration is a common complication and can lead to secondary infection. Large hepatic hemangiomas or hemangioendotheliomas may result in hepatomegaly, anemia, thrombocytopenia, and high-output heart failure.
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