Hemangioma natural history, complications and prognosis

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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.

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]

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.

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.

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.

Rapid growth of hemangiomas can lead to exhaustion of blood supply with resulting:^[2]

Common complications of infantile hemangioma include:^[3]

Prognosis is generally good.

↑ 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.