Hemangioma in children and adults: types of tumors andtreatment methods

Hemangioma in children and adults: types of tumors and treatment methodsBig
the problem of modernity and the consequence of the eternal employment of the population,
especially women, was the frequent appearance of babies with focal
skin lesions of red or wine color. Most often this
the disease – hemangioma – occurs in babies and
fully passes to the period of puberty. However, for a number
reasons (in particular, due to poor environmental conditions and
constant stress) neoplasm can also occur in adults
people.

General information

General information о гемангиоме Hemangioma is
benign tumor most often overgrown
vascular tissue. Has the appearance of a birthmark of bright red,
crimson, wine or bluish color of various shapes on
skin surface. May have smooth or blurred edges, as well
smooth or bumpy surface.

Usually, она не доставляет пациентам каких-либо неудобств.
However, when расположении на участках тела, подверженных постоянному
friction (legs, armpits, groin area) or pressure,
such formations may bleed or be supplemented by ulcers,
thereby creating a certain discomfort.

Most often hemangiomas are located on the face and head, however
are found both on the rest of the body and inside it. If a
hemangioma is located on the bones or internal organs, it can
be accidentally detected during a general examination.

Withчины возникновения

There is no reliable information on factors provoking
disease, scientists have only identified a stable statistical dependence.
Hemangioma itself is a collection of vessels prone to
sprawl. The vascular system is laid around 6 week
pregnancy, and the greatest risk of such tumors is
children whose mothers in this period had acute respiratory infections and were taking aggressive
medications for their treatment.

Unfortunately, a woman often learns about pregnancy in a period of 10−12
weeks, which is why the percentage of babies with this disease
steadily increasing. It is noted that the risk of a tumor in
girls 3-4 times (and according to some data, 5-6 times) more than
boys This is due to the fact that the active growth of blood vessels
affect female hormones.

Specialists put forward several hypotheses why they appear
hemangiomas:

  1. The theory of the The theory of the “misguided
    клеток»
    . The most reasonable and supported by statistics
    version that is based on the fact that the development of vascular cells from
    mesenchyme was for some reason violated. Originally on
    the first stage of the formation of the circulatory system are laid
    capillaries, which are then transformed into veins and arteries. With
    forming a network of blood vessels in and around organs can
    remain unused capillary tissue cells. In normal
    condition they gradually disappear before birth. However, in a number
    cases the mechanism fails, resulting in small vessels not
    disappear, and begin to grow, reaching the stage of tumor-like
    formations. That is why most often hemangiomas are found in
    children immediately at birth or develop in the first months of life. AT
    most at risk are premature babies, a hormone
    growth which is produced several times more intense.
  2. Withчины возникновения гемангиомыFissural (slit)
    теория
    . Based on the frequent location of hemangiomas in
    areas of the mouth, eyes and ears. ATозникновение опухоли связывают с
    violation of the development of these bodies laid out in the seventh week
    сосудистой и нервной tissues. But this opinion does not explain the appearance
    tumors in other areas of the skin, under the skin and on the inner
    organs.
  3. Плацентарная теория. Proponents of this hypothesis
    suggest that cells enter the fetal bloodstream
    placenta endothelium. While the baby is developing, the mother’s immune system
    does not allow tissue to grow, but after birth begins
    active growth of vessels with the formation of hemangiomas.

The mechanism of growth of a vascular tumor

Although the reason why the moles appear is not established,
the mechanism of their formation from underdeveloped
capillary cells of the embryo. The only factor triggering
the growth of the vascular cells of the fetus, is tissue hypoxia.
A natural way for the body to get more oxygen is
increase the number of ways to deliver it, that is, capillaries.

Поэтому выделена группа факторов риска,
most commonly associated with fetal hypoxia, which increase the risk
развития hemangiomas:

  1. Multiple pregnancy. The development of several embryos
    increases the risk of hemangioma.
  2. Intoxication.
  3. ATозраст матери. The older the woman, the more likely
    various anomalies in the child, including hemangiomas.
  4. Placental insufficiency. With нарушении структуры
    the placenta or its functions disrupt the supply of the fetus with oxygen and
    other useful micronutrients.
  5. Trauma during childbirth. Various injuries during childbirth, long
    or fast delivery, the characteristics of the birth canal and the size of the baby can
    cause hypoxia. AT таких случая часто гемангиома поражает
    scalp and / or face.
  6. The mechanism of growth of a vascular tumorEclampsia. Drastic change
    maternal blood pressure down to loss of consciousness and seizures
    also leads to fetal hypoxia.
  7. Smoking during pregnancy. The smoking process replaces part
    inhaled oxygen by smoke, and therefore decreases the amount
    кислорода, которое получает ребёнок.
  8. Prematurity Special substance surfactant which
    provides light breathing of the infant, in sufficient quantities
    accumulates only by 36 weeks. Therefore, premature babies
    high risk of tissue hypoxia.

Stage of the disease

Most often, doctors in the diagnosis of this disease in children
choose waiting tactics. The development of hemangiomas has several
чётких признаков и протекает в несколько
stages:

  1. The period of intensive growth. Manifested immediately after childbirth and
    fades by the end of the first year of life. Tumor growth goes on all
    directions: its area increases, as well as the depth of the lesion.
    The process proceeds at different speeds from barely noticeable to
    catastrophic (a few millimeters a day). It is this
    period of possible complications in the form of bleeding, ulceration and
    damage to internal organs.
  2. The period of stunting. Active production of growth hormone
    ends by about a year. At the same time, it slows down or
    the growth of vascular neoplasms stops completely. Further
    growth continues commensurate with the growth of the child to 5−6 years.
  3. The period of reverse development. After a while may
    come regression period. It is expressed in a color change on
    less bright. Over time, the capillary tissue is completely replaced
    skin in cases with small hemangioma or scar tissue,
    if the lesion was large and affected the deep layers of the skin. This
    The process is observed in about 2% of cases.

Types of hemangiomas

In part, it is a large variety of hemangiomas that causes
difficulties with their systematization. There are several
classifications, the division in which goes by the location of tumors and
participating in their structure of tissues. They are closely related,
therefore, they are considered in parallel when making a diagnosis
indicate membership in both classes.

The classification by location of a tumor is based on where
focal damage is mainly localized:

  1. Стадии гемангиомыSkin hemangiomas. They have smooth contours and
    weakly bumpy surface. Affect the skin and partially
    subcutaneous fat. Grow, as a rule, increasing their
    area, but they can penetrate into the dermis.
  2. Subcutaneous. On the surface are expressed tubercle
    reddish bluish color, has uneven, fuzzy edges. With
    The pressure subsides and becomes paler. During the crying baby
    may swell from blood flow and even burst.
  3. Hemangiomas of the internal organs (parenchymal). Amaze
    internal organs, especially those with increased blood supply,
    for example, liver and kidneys. Can affect the testicles and adrenal glands,
    stomach and other abdominal organs.
  4. Lesions of the musculoskeletal system. Stand out from
    distribution of vascular tissue in the bones, muscles. At risk
    there are also ligaments and joints.

In addition, tumor formations differ in structure.
The difference in structure and location often determines the degree
the dangers of this harmless, at first glance, neoplasms:

  1. Capillary (simple or flat) hemangiomas. Usually,
    refer to the skin type. Expressed in the growth of capillary
    nets have smooth contours, smooth, slightly rising above
    the rest of the skin surface. Often the vascular spot has the form
    asterisks: central spot with radially diverging from it
    small expanded vessels.
  2. Types of hemangiomasCavernous. Participate in their structure
    vessels (caverns) filled with blood. More pronounced on the body
    due to tuberosity, however, with subcutaneous location may be
    almost indistinguishable from capillary.
  3. Combined. Tumors involving capillary and
    cavernous formations. Usually, поражают большие участки кожи
    (up to 10 square centimeters).
  4. Racemose hemangioma. A rare type of tumor that is formed
    plexuses of flattened vessels on the scalp and
    complicated by fistula.
  5. Mixed type. Hemangiomas may be accompanied by an overgrowth.
    nerve tissues, leukocytes, blood clots, etc. From the type of prevailing
    tissues may change the appearance and consistency
    tumors.

Possible complications

The main danger of any hemangioma is its rapid growth with
germination in the internal organs. It may break them.
functioning. Sharp increase in cavernous size
hemangiomas in the liver, for example, can lead to extensive
bleeding in the abdominal cavity. The consequences are often
lethal to the patient.

Often the development of hemangioma proceeds without alarming symptoms, and
simple skin or subcutaneous birthmarks cause discomfort
aesthetic nature.

Possible complications гемангиомыHowever, close proximity to
eyes or auricles may impair the function of these
organs: retinal detachment, destruction of eardrums,
therefore, they begin to be treated immediately upon detection.

Complications of hemangiomas are also bleeding, the appearance
язв и трещин на коже вокруг tumors. With стремительном they are tall
have a squeezing, sometimes damaging effect on the fabric
organs next to which are localized. For example, located in
neck growth during germination can squeeze
trachea that makes breathing difficult.

Serious hemangiomas on bones, especially
spine, can lead to impaired motor functions
organism.

Damage to the spinal cord provokes systemic failures in
the functioning of the pelvic organs and intestines. Symptoms such
гемангиомы являются:

  • muscle atrophy of the legs;
  • incontinence of feces and urine;
  • ulcers on the soles of the feet;
  • paresis of the leg muscles.

Another important complication during this disease is
the accession of infections.

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Frequent bleeding and skin disorders contribute to
the introduction of harmful microflora, which adversely affects the health
man in general.

Diagnostic methods

A distinctive feature of hemangiomas is that it
benign lesions that are practically not reborn
into malignant or cancerous. Extensive growth lasts for
six months from the moment it appears, then it fades out, and the tumors
gradually go away, fully regressing by 10–15 years.

Diagnostic methods гемангиомыFor the development of hemangioma
need to be observed by a specialist. Usually diagnosing
the surgeon is engaged, however, depending on the complexity of the flow
An oncologist, a dermatologist, an infectious disease specialist and a therapist may be involved.
Of diagnostic methods distinguish laboratory and
instrumental.

The first group of studies is based on the study of blood count.
With гемангиоме может развиваться анемия и тромбоцитопения. Both
diseases are associated with the absorption of blood clots by hemangioma and possible
bleeding. However, the composition of the blood can not fully reflect
current state and development of hemangioma. Among laboratory methods
allocate some more directions:

  • thermometry;
  • thermography;
  • ultrasound procedure;
  • CT scan;
  • Magnetic resonance imaging;
  • angiography;
  • biopsy.

УЗИ как метод диагностики гемангиомы

Thermometry and thermography are based on the fact that the area where
vessels expand, it has an increased blood supply, and therefore,
images will be visible thermal anomalies. In addition, an elevated halo
around hemangiomas themselves, internal organs and bones will show
реальные размеры tumors.

Ultrasound as a diagnostic method is the most informative, since it is based
on different echogenicity of tissues in the human body. Capillary
hemangioma will be expressed in foci with increased echogenicity. She is
empty, and therefore well reflects the sound. Filled with blood
the cavernous structure, in contrast, will have a reduced
echogenicity, since the blood has a greater ability to
reflection of sound waves. The pictures in such cases will be visible
oval formations up to 1 cm.

Computed tomography and MRI have a number of contraindications, including
including children’s age. However, if the hemangioma threatens the work
vital organs such studies are imperative for
more accurate localization and allow the surgeon to conduct as much as possible
less traumatic surgery to remove overgrown vessels.

Ways to reduce and remove гемангиомы Angiography
performed in conjunction with an MRI and also has contraindications. Into the vein
or the artery from which the hemangioma feeds is injected with a special
contrast agent that stains blood and changes display
vessels in the pictures. Using this procedure, evaluate the area
distribution of abnormally overgrown vessels. Holding
research is accompanied by the risk of rupture of blood vessels and strong
allergic reaction, so it is prescribed in severe cases,
when it depends on how accurately the tumor boundaries are determined
success of the operation.

Biopsy is the collection of live tumor tissue to examine
their structure and cellular composition. Since this is surgical, at least
and a point effect, it can be complicated by bleeding, to
the same can confirm the diagnosis without this study.
The exception is mixed hemangiomas when there is a risk of transition.
education in the category of malignant.

Ways to reduce and remove

Since the list of complications with the rapid growth of hemangiomas
is quite extensive, several methods were developed to combat
sprawling vessels. There are both surgical methods, so
and cosmetic effects.

Physical procedures

Physical procedures против гемангиомы

Hemangiomas located deeply and affecting the internal
organs removed by surgical intervention. However, when
very large sizes vascular formations are reduced in size
physical influences. This may be laser cauterization.
(especially in the area of ​​eyes and ears).

In cases where a simple mole delivers only aesthetic
inconvenience and has a small area, it can be removed without
surgical intervention. To do this, use laser therapy.
or cryodestruction.

Cryodestruction is based on exposure to liquid nitrogen, while
affected tissues die off without scarring. May also be
applied sclerotherapy based on the ability
some chemicals clog and destroy the vascular
the cloth.

Удаления гемангиомы

Among the physical methods also distinguish electrocoagulation. She is
represents the destruction of vascular tissue through exposure
high-frequency pulses of electric current. Clear advantage
method – the practical absence of bleeding.

Close focus radiotherapy based on radiation
affected vessels directed x-rays that
leads to the death of vascular tissue. This метод характеризуется
adverse effects on the body by radiation, therefore not
used to treat hemangiomas in children and not used as
self therapy

Drug treatment

In addition to physical impacts from the outside, destruction is possible.
tumors from the inside. There are drugs that slow growth
vascular neoplasms and reduce them. Drug action not
as effective as physical procedures, therefore it is applied as
additional method in the preoperative period.

The action of drugs blocks the growth of vascular tissues with their
subsequent destruction.

Drug treatment гемангиомы

Hormonal steroid stimulation is aimed at narrowing
capillaries, their exsanguination and dying off with formation of cicatricial
tissues. Well proven funds aimed at
stopping or slowing down cell division.

Hemangioma can also occur in an adult. Important to follow
over the tumors, as they carry with them certain
danger. There is a risk of developing secondary hemangiomas on the legs (in
particular on the inside of the thigh and lower leg) even after
removal of the tumor at an early age.

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