Hemangioma natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated, 20% of patients with hemangioma may progress to develop [[ulceration]], [[hemorrhage]], [[infection]], and [[High output failure|high output cardiac failure]].<ref name="HassanShreef2014">{{cite journal|last1=Hassan|first1=Basheir A.|last2=Shreef|first2=Khalid S.|title=Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children|journal=Dermatology Research and Practice|volume=2014|year=2014|pages=1–5|issn=1687-6105|doi=10.1155/2014/541810}}</ref> Common complications of hemangioma include [[ischemia]], [[necrosis]], [[ulceration]], and [[bleeding]].<ref name="RichterFriedman2012">{{cite journal|last1=Richter|first1=Gresham T.|last2=Friedman|first2=Adva B.|title=Hemangiomas and Vascular Malformations: Current Theory and Management|journal=International Journal of Pediatrics|volume=2012|year=2012|pages=1–10|issn=1687-9740|doi=10.1155/2012/645678}}</ref> | If left untreated, 20% of patients with hemangioma may progress to develop [[ulceration]], [[hemorrhage]], [[infection]], and [[High output failure|high output cardiac failure]].<ref name="HassanShreef2014">{{cite journal|last1=Hassan|first1=Basheir A.|last2=Shreef|first2=Khalid S.|title=Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children|journal=Dermatology Research and Practice|volume=2014|year=2014|pages=1–5|issn=1687-6105|doi=10.1155/2014/541810}}</ref> Common complications of hemangioma include [[ischemia]], [[necrosis]], [[ulceration]], and [[bleeding]].<ref name="RichterFriedman2012">{{cite journal|last1=Richter|first1=Gresham T.|last2=Friedman|first2=Adva B.|title=Hemangiomas and Vascular Malformations: Current Theory and Management|journal=International Journal of Pediatrics|volume=2012|year=2012|pages=1–10|issn=1687-9740|doi=10.1155/2012/645678}}</ref> Prognosis is generally good. | ||
==Natural history== | ==Natural history== | ||
*Hemangiomas are vascular tumors that are rarely apparent at birth, grow rapidly during the first six months of life, involute with time and do not necessarily infiltrate but can sometimes be destructive.<ref name="RichterFriedman2012">{{cite journal|last1=Richter|first1=Gresham T.|last2=Friedman|first2=Adva B.|title=Hemangiomas and Vascular Malformations: Current Theory and Management|journal=International Journal of Pediatrics|volume=2012|year=2012|pages=1–10|issn=1687-9740|doi=10.1155/2012/645678}}</ref> | *Hemangiomas are vascular tumors that are rarely apparent at birth, grow rapidly during the first six months of life, involute with time and do not necessarily infiltrate but can sometimes be destructive.<ref name="RichterFriedman2012">{{cite journal|last1=Richter|first1=Gresham T.|last2=Friedman|first2=Adva B.|title=Hemangiomas and Vascular Malformations: Current Theory and Management|journal=International Journal of Pediatrics|volume=2012|year=2012|pages=1–10|issn=1687-9740|doi=10.1155/2012/645678}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]
Overview
If left untreated, 20% of patients with hemangioma may progress to develop ulceration, hemorrhage, infection, and high output cardiac failure.[1] Common complications of hemangioma include ischemia, necrosis, ulceration, and bleeding.[2] Prognosis is generally good.
Natural history
- Hemangiomas are vascular tumors that are rarely apparent at birth, grow rapidly during the first six months of life, involute with time and do not necessarily infiltrate but can sometimes be destructive.[2]
- Hemangiomas follow a predictable course with three distinct developmental phases:[2]
- Proliferation phase
- Quiescence phase
- Involution phase
Proliferation phase
- In most hemangiomas, eighty percent of proliferation occurs by three months of life but may last longer.[2]
- During proliferation, rapid growth can lead to exhaustion of blood supply with resulting ischemia, necrosis, ulceration, and bleeding.
Quiescence phase
- Following proliferation, hemangiomas enter a slower or no growth phase, known as quiescence.[2]
- This phase typically lasts from nine to twelve months of age.
Involution phase
- The final and unique phase of the hemangioma lifecycle is involution.[2]
- This phase is marked by graying of the overlying skin and shrinking of the deeper components.
- At the final stages of involution, a fibrofatty protuberance may remain.
Complications
Rapid growth of hemangiomas can lead to exhaustion of blood supply with resulting:[2]
Ophthalmic complications
Common complications of infantile hemangioma include:[3]
- Amblyopia
- Strabismus
- Proptosis
- Exposure keratopathy
- Compressive optic neuropathy
Prognosis
Prognosis is generally good.
References
- ↑ Hassan, Basheir A.; Shreef, Khalid S. (2014). "Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children". Dermatology Research and Practice. 2014: 1–5. doi:10.1155/2014/541810. ISSN 1687-6105.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Richter, Gresham T.; Friedman, Adva B. (2012). "Hemangiomas and Vascular Malformations: Current Theory and Management". International Journal of Pediatrics. 2012: 1–10. doi:10.1155/2012/645678. ISSN 1687-9740.
- ↑ Callahan, Alison B.; Yoon, Michael K. (2012). "Infantile hemangiomas: A review". Saudi Journal of Ophthalmology. 26 (3): 283–291. doi:10.1016/j.sjopt.2012.05.004. ISSN 1319-4534.