Hemangiomas - harmless lesions or a warning signal? What is worth knowing?

What are hemangiomas?

Vascular tumors (Latin: angioma) are malignant tumors of vessels that can occur in both the skin and internal organs. Most are benign in nature, although malignant varieties also exist. The exact causes of hemangiomas are not fully understood, but genetic predisposition is considered the main factor. Interestingly, these lesions often appear in children, sometimes from birth.

Types of hemangiomas - detailed breakdown

Hemangiomas are a diverse group of neoplastic lesions. The vast majority of them are harmless and do not require treatment, but for some types medical intervention is necessary. Therefore, it is extremely important to regularly monitor the lesions and consult a doctor if they grow rapidly or if alarming symptoms appear.

Hemangiomas (hemangiomas)

This is the most common group of hemangiomas, resulting from excessive growth of blood vessels. They can appear in various places - on the skin, in subcutaneous tissue, as well as in internal organs. Due to the structure, several types of hemangiomas are distinguished.

• Capillary hemangiomas (capillary hemangiomas). This is the most common type of hemangioma, consisting of small capillaries. The lesions usually occur on the skin and mucous membranes, most often in children, but are not painful They are flat or slightly convex, have an intense red color and often spontaneously disappear within a few years. 
• Venous hemangiomas. They arise from oversized veins. The lesions are softer to the touch and may have a bluish tint. They occur deeper in the subcutaneous tissue and sometimes cause discomfort, especially when they reach larger sizes, as they then begin to put pressure on adjacent tissues. They can appear in any part of the body, and in the case of large hemangiomas, treatment such as sclerotherapy or surgical removal is recommended.
• Arterial hemangiomas. A less common type of hemangioma, arising from dilated arteries. Its hallmark is a palpable pulsation, consistent with the heartbeat, which results from the flow of arterial blood through the lesion. They are more problematic due to the risk of bleeding and often require surgical intervention or embolization to prevent complications.
• Mixed hemangiomas (mixed hemangiomas). They consist of different types of vessels - capillary, venous and arterial. Their appearance and behavior depend on the predominant type of vessels in the lesion. They can occur both on the surface of the skin and deeper in the tissues. They require accurate diagnosis and individually selected treatment.

Lymphangiomas (lymphangiomas)

These are tumors originating from lymphatic vessels, occurring much less frequently than hemangiomas. They can appear in various parts of the body, although they are most common around the head, neck and armpits. Based on the type of structure, they are divided into three subtypes.

• Simple lymphangiomas (simple lymphangiomas). They consist of dilated lymphatic vessels and usually take the form of small, soft nodules similar in color to the skin. They are usually benign and not painful, but are often removed for cosmetic reasons or when they cause discomfort.
• Cavernous lymphangiomas. They are composed of larger spaces filled with lymph, resulting in characteristic swelling. They often reach considerable size, which can lead to compression of adjacent tissues. They can cause deformities or impede daily function, and treatment usually involves surgical removal of the lesion.
• Cystic lymphangiomas (cystic lymphangiomas). The largest and rarest type of lymphangioma. The lesions take the form of large, cystic fluid-filled structures. They occur mainly in the neck and armpit areas, often in newborns and young children. They can cause significant deformity and pressure on adjacent organs. They require surgical treatment, especially when they cause difficulty breathing or eating.

Malignant vascular tumors

Although most hemangiomas are benign, there are malignant counterparts that pose a threat to the patient's health and life. 

• Hemangiosarcoma (angiosarcoma). A rare but aggressive malignant neoplasm of blood vessels that grows rapidly, destroys surrounding tissues and metastasizes. It occurs most often on the scalp and face in the elderly, but can also appear in internal organs. In this type of case, rapid oncological treatment - surgery, radiation therapy or chemotherapy - is necessary.
• Malignant hemangiopericytoma. A tumor derived from pericytes (cells surrounding blood vessels). It occurs rarely, but is characterized by high malignancy and a propensity to metastasize. As with hemangiosarcoma, surgical and oncological treatment is used.

Read also: The way to beautiful legs - when is it worth consulting a vascular surgeon?

What do hemangiomas look like and how to recognize them?

The most common hemangiomas appear as red, pink or purple patches or nodules on the skin, which are caused by excessive growth of blood vessels. Lymphangiomas, on the other hand, can be similar in color to the skin or slightly yellowish.

Characteristic features of hemangiomas

• Color - from light pink to dark red, depending on the number and depth of blood vessels.
• Consistency - they can be soft to the touch, and sometimes fade on pressure and return to their original color after it subsides.
• Shape - they are usually round or oval with distinct edges.
• Location - they can occur on any part of the body, but most often appear on the face, neck, torso and extremities.

Types of hemangiomas by appearance

• Flat capillaries - look like red or pink spots on the skin, often appear in newborns. Many of them spontaneously disappear over time.
• Nodular hemangiomas - are convex, nodular in structure and intensely red in color. They usually appear in the first months of a child's life.
• Subcutaneous hemangiomas - are not visible on the surface of the skin, but can cause palpable thickening under the skin. Their presence is confirmed by a bluish or purple coloration of the skin.

How do you recognize a hemangioma that may require medical consultation?

If a hemangioma grows rapidly and is accompanied by additional symptoms, consult a doctor about the changes. It is worth remembering that hemangiomas usually do not cause pain. However, if there is discomfort, pain or bleeding, you should see a specialist.

Hemangiomas in internal organs, t especially if located in the liver or brain, can cause serious symptoms and require careful diagnosis.

The diagnosis of a hemangioma is usually made on the basis of a physical examination. If in doubt, the doctor may order additional tests, such as an ultrasound, MRI or CT scan, to assess the depth of the lesion and its impact on surrounding tissues.

Can hemangiomas be dangerous to health?

Most hemangiomas are benign lesions that pose no health risk and require only regular observation. However, in some cases, especially when they involve internal organs, they can lead to serious health complications. Alarming symptoms include abdominal pain, dizziness, seizures and, in extreme cases, dangerous internal bleeding.

It is also worth remembering that hemangiomas also take on a malignant form. Among the most dangerous cancers are the already mentioned hemangiomas, which grow rapidly, destroy surrounding tissues and give metastasis. In such situations, immediate treatment is necessary.

What are the treatments for hemangiomas?

The first step in treating hemangiomas is often pharmacotherapy. Glucocorticosteroids and beta-blockers are used to shrink the vessels and reduce their visibility.

Laser therapy

Laser therapy is one of the most modern and effective methods of treating hemangiomas, especially those located superficially. Thanks to the precise action of the laser beam, it is possible to selectively destroy the blood vessels of which the hemangioma is composed, without damaging the surrounding tissues. The laser light is absorbed by the hemoglobin contained in the vessels, resulting in their coagulation and subsequent natural absorption by the body.

The procedure is minimally invasive, which means it does not require a long recovery. The safety of laser therapy also makes it suitable for children and people with sensitive skin. Depending on the size and depth of the hemangioma, the treatment may require several sessions to achieve the desired cosmetic and therapeutic effect.

Foam sclerotherapy

Foam sclerotherapy is a proven and effective method of treating hemangiomas and other vascular lesions by injecting a sclerotic agent directly into the affected vessels. The agent causes irritation of the blood vessel walls, which leads to their shrinkage and then complete closure. Once closed, the vessel gradually transforms into fibrous tissue and is absorbed by the body.

Foam sclerotherapy uses a special form of the drug in the form of foam, which increases the effectiveness of the treatment. The foam adheres better to the walls of the vessels and stays longer, so it works over a larger area and closes the affected vessels faster.

Vascular surgery

Vascular surgery is used in difficult cases where other, less invasive treatment methods are unsuccessful or when the hemangioma is too large, deeply located or causes severe clinical symptoms. This is especially true for hemangiomas located in internal organs, where there is a risk of complications, including internal bleeding or pressure on neighboring structures.

FAQ

What do hemangiomas look like?

Hemangiomas most often look like red, pink or purple spots or nodules on the skin. Lymphangiomas are usually colorless or similar in color to the skin. The lesions can be flat or convex, and their size and shape depend on the type of hemangioma.

Can hemangiomas disappear on their own?

Yes, many hemangiomas, especially in children, disappear spontaneously within a few years. This applies mainly to capillary hemangiomas, which often do not require treatment, only regular observation.

Are hemangiomas dangerous to health?

Most hemangiomas are benign and pose no health risks. However, hemangiomas of internal organs can be dangerous because of the risk of bleeding or pressure on important structures.

Is laser therapy painful?

Laser therapy is a minimally invasive procedure and usually does not cause much discomfort. If necessary, local anesthesia is used to make the patient more comfortable.

When is hemangioma surgery necessary?

Surgery is necessary for large or deep-seated lesions that cause discomfort, grow rapidly, threaten the patient's health or do not respond to other treatments.

What are the complications of untreated hemangiomas?

For most benign hemangiomas, there are no complications. However, hemangiomas of internal organs can lead to dangerous hemorrhages, and rapidly growing malignant lesions increase the risk of metastasis.

Is every skin lesion with a red coloration a hemangioma?

Not every red lesion on the skin is a hemangioma. They can be other vascular lesions, such as vascular spider veins, vascular malformations or telangiectasias. It is advisable to consult a dermatologist or vascular surgeon for a correct diagnosis.

How to prevent the formation of hemangiomas?

There are no effective methods to prevent hemangiomas, as their causes are mainly genetic. Regular check-ups with a doctor and avoiding excessive sun exposure reduce the risk and enlargement.

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