Hemangioma in newborns
The content of the article:
- Causes of hemangioma in newborns and risk factors
- Forms of the disease
- Disease stages
-
Symptoms
- Capillary hemangiomas
- Cavernous hemangiomas
- Combined hemangiomas
- Mixed hemangiomas
- Diagnostics
- Hemangioma treatment in newborns
- Possible complications and consequences
- Forecast
- Prevention
Hemangioma in newborns is a benign vascular tumor that is one of the most common benign neoplasms in children.
Hemangioma is detected in 1-10% of newborns, girls are more susceptible to the disease. In about 80% of cases, the tumor is localized on the skin, in 60% of cases, hemangiomas are recorded in newborns on the head and neck. The most intensive growth of a neoplasm occurs in the first six months of life. Then the growth of the neoplasm usually slows down, in 6-7% of cases, the reverse development (involution) of the tumor occurs.
Hemangioma in a newborn
Causes of hemangioma in newborns and risk factors
The causes of hemangioma in newborns are not fully understood. It was found that the occurrence of the disease is facilitated by anomalies in the development of blood vessels in the prenatal period. The development of hemangioma, most likely, occurs against the background of damage to angioblasts (cells from which the blood vessels of the embryo are subsequently formed) at the 7-10th week of pregnancy.
Risk factors during pregnancy include:
- taking teratogenic drugs;
- infectious, especially viral, diseases;
- exacerbation or development of endocrine disorders;
- rhesus conflict;
- multiple pregnancy;
- age over 35;
- unfavorable ecological situation.
The pathological course of pregnancy and prematurity are also important - hemangiomas are more often found in children born prematurely.
Rh-conflict refers to risk factors for the formation of hemangioma in a newborn
Forms of the disease
Depending on the morphological signs, the following types of hemangiomas are distinguished:
- simple, or capillary;
- cavernous, or cavernous;
- combined (combining signs of simple and cavernous);
- mixed (in addition to vascular tumors, other elements are present).
Hemangiomas in newborns can be single and multiple, and in size - small, large or extensive.
According to the rate of development of hemangiomas, there are:
- with slow growth;
- with fast growth;
- with a lack of growth.
Disease stages
In the clinical picture of hemangiomas, a stage of active tumor growth, a stage of cessation of growth and, in some cases, a stage of reverse development are distinguished.
Symptoms
Hemangioma in newborns is usually found in the first days, less often a week of life. Usually, neoplasms are localized on the scalp, face (nose, cheeks, eyelids), mucous membranes of the oral cavity, genitals, on the upper body, upper and lower extremities. Less commonly, hemangiomas form in internal organs and bones.
Hemangioma in newborns is a flat or lumpy-nodular or cavernous neoplasm that rises above the skin surface, with a color ranging from pale pink to burgundy with a cyanotic shade, ranging in size from 1 mm to 10 cm in diameter, and sometimes even more. Superficial hemangiomas are characterized by temperature asymmetry: vascular swelling to the touch of a higher temperature than the surrounding tissues.
Capillary hemangiomas
Capillary hemangioma in newborns slightly protrudes above the surface of the skin and usually does not extend to the deep layers of the skin. The size usually does not exceed 1 cm in diameter.
It looks like a capillary hemangioma
Capillary hemangioma of the eye is formed in the form of a limited growth of bright red color. The tumor rises above the surface of the skin, increases in size when the child cries or screams, and turns pale when pressed. Capillary hemangioma of the eye usually occurs in the upper eyelid, can spread into the orbit. In the case of regression of the neoplasm, a spot of hypopigmentation or a scar remains in its place.
Cavernous hemangiomas
Cavernous hemangioma in newborns has a soft structure. Most often it is localized on the skin, but it can also form in organs with abundant blood supply (brain, lungs, liver, spleen, kidneys, adrenal glands). As a rule, with internal localization, cavernous hemangioma is asymptomatic, being detected either accidentally during examination for another reason or with the development of bleeding, which is usually caused by trauma. Bleeding from an internal hemangioma can be life threatening.
Cavernous hemangioma in a newborn
Cavernous hemangioma of the eye has the appearance of a clearly demarcated pink spot that does not fade when pressed. With the progression of the pathological process, the neoplasm acquires a purple or dark red color. This form of hemangioma is usually not prone to spontaneous regression. The skin under the tumor may become rough, loose, nodular, inflamed, or bleed.
Combined hemangiomas
Combined hemangiomas have signs of both capillary and cavernous, cutaneous and subcutaneous parts. Clinical manifestations depend on the predominance of the capillary or cavernous component.
Mixed hemangiomas
The mixed form of hemangioma is characterized by a complex structure and includes elements of vascular and other (lymphoid, connective, nervous) tissues. The appearance and consistency of such neoplasms depend on their constituent components.
Spontaneous regression of hemangioma begins with the appearance of pale-colored areas in the center of the neoplasm, which gradually spread to the periphery of the tumor. The tumor regresses within several years.
Diagnostics
For hemangiomas in newborns, the examination is carried out by a pediatrician, dermatologist and surgeon. Depending on the location of the neoplasm, it may be necessary to consult an ophthalmologist, otorhinolaryngologist, urologist, gynecologist, etc.
To determine the type of hemangioma and develop treatment tactics, the results of physical diagnostics and additional studies are used.
To determine the depth of the spread of the neoplasm and the features of its structure, an ultrasound examination of the skin tumor is carried out with the measurement of the blood flow velocity in the parenchyma of the neoplasm and in the peripheral blood vessels.
Angiography can be used to study the characteristics of the blood supply of a vascular tumor. In order to determine the involvement of the surrounding structures in the pathological process, it may be necessary to conduct an X-ray (chest, skull bones, etc.) or magnetic resonance imaging.
Ultrasound of hemangioma allows you to determine the depth of the spread of the tumor and features of its structure
The detection of the Kazabach-Meritt syndrome is carried out by determining the number of platelets and performing a coagulogram.
Differential diagnosis of hemangioma is carried out with glomus angioma, squamous cell carcinoma, pyogenic granuloma, cysts, nevi, and other malformations of blood vessels.
Hemangioma treatment in newborns
Capillary hemangiomas sometimes resolve spontaneously, therefore, with a standard uncomplicated course of the disease, as a rule, expectant tactics are chosen.
Hemangiomas in newborns on the head, in the mouth, in the neck, anogenital area, as well as neoplasms showing aggressive growth, should be treated as early as possible, literally in the first weeks of life. Early treatment is also indicated for the development of bleeding, infection, or necrosis.
Cryotherapy is used for hemangiomas up to 2-2.5 cm in size, located not on the face, as well as at low blood flow velocity in them. Cryodestruction is the best method for removing hemangiomas located on the back.
For hemangiomas located in anatomically significant places (mucous membrane of the oral cavity, eyelid, ear region, etc.), a sclerosis method can be used, during which a sclerosant is introduced into the neoplasm - a substance that causes the replacement of tumor tissue with connective tissue. This method is usually used to treat cavernous hemangiomas.
Electrocoagulation is used to remove neoplasms that are no more than 5 mm in diameter, as well as to remove the remnants of the tumor after treatment with other methods.
Removal of hemangiomas in newborns is performed using minimally invasive methods
Radiation therapy is not used to treat hemangiomas in newborns. Its use is allowed only in children older than 6 months for the treatment of neoplasms located on the internal organs, as well as subcutaneous cavernous hemangiomas.
Surgical resection of hemangiomas in newborns is not performed, and rarely in older children. If necessary, they resort to it not earlier than the child reaches 3 months. The indications for surgery are the rapid progression of the tumor and its large size.
With deep localization of the neoplasm, inaccessible location of the tumor, a large area of the lesion, several methods are combined.
Possible complications and consequences
Hemangiomas in newborns can cause bleeding, especially when there is a bleeding disorder. Another complication is ulceration of the neoplasm, which occurs when the tumor is localized in the genital area and in other easily traumatized areas.
The growth of a vascular tumor in depth can lead to compression of anatomical structures and disruption of the functioning of nearby organs.
Forecast
In about 7% of cases, hemangiomas in newborns progress during the first year of life, and then undergo a regression, which, however, can be prolonged - sometimes until puberty. In other cases, the prognosis is also favorable, especially with timely adequate treatment.
Prevention
Prevention of hemangioma in newborns is carried out during pregnancy. For this purpose it is recommended:
- early registration of a pregnant woman, timely passage of all necessary examinations, i.e. monitoring of health status;
- rejection of bad habits;
- avoiding excessive physical exertion;
- avoiding contact with infectious patients, as well as large gatherings of people during seasonal epidemics of viral infections.
With hemangioma in a newborn, parents should consult with specialists as early as possible about the timely initiation of treatment, which will provide a good cosmetic effect.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
