Big
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
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:
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.
Fissural (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.- 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:
- Multiple pregnancy. The development of several embryos
increases the risk of hemangioma. - Intoxication.
- ATозраст матери. The older the woman, the more likely
various anomalies in the child, including hemangiomas. - Placental insufficiency. With нарушении структуры
the placenta or its functions disrupt the supply of the fetus with oxygen and
other useful micronutrients. - 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. 
Eclampsia. Drastic change
maternal blood pressure down to loss of consciousness and seizures
also leads to fetal hypoxia.- Smoking during pregnancy. The smoking process replaces part
inhaled oxygen by smoke, and therefore decreases the amount
кислорода, которое получает ребёнок. - 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:
- 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. - 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. - 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:
Skin 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.- 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. - 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. - 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:
- 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. 
Cavernous. 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.- Combined. Tumors involving capillary and
cavernous formations. Usually, поражают большие участки кожи
(up to 10 square centimeters). - Racemose hemangioma. A rare type of tumor that is formed
plexuses of flattened vessels on the scalp and
complicated by fistula. - 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.
However, 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.
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.
For 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.
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.
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
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.
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.
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.
