Modern medicine, as you know, does not stand still in its development. Today, unfortunately, not all diseases are amenable to drug treatment; in some cases, surgery is required. surgical intervention. These are primarily neoplasms, including malignant ones.

We have all met people in our lives who have a large birthmark Red. In fact, most often it is an ordinary hemangioma. It is a benign vascular tumor that appears as reddish or purple spots that rise above the skin by approximately 1 mm. In this article we will explain in more detail how this pathology differs in children.

general information

Hemangiomas in children, as noted above, are a tumor that comes from vascular tissue. In medicine, there are two phases of its development: the stage of proliferation (growth) and involution (reverse development).

This benign formation is a consequence of impaired vascular formation in the embryonic period.

Hemangiomas in children, as a rule, appear in the first two weeks of life and appear within a year. Recently, the number of congenital benign tumors has noticeably increased.

Such neoplasms are distinguished by their rapidly developing nature. On the other hand, spontaneous disappearance of hemangioma may occur even without surgical intervention or drug treatment.

Prevalence of vascular neoplasm

According to available data, in different populations, about 10% of newborn children have this pathology.

• Hemangiomas occur several times more often in girls. In addition, it is women who are predominantly diagnosed with complicated forms.
• In the European population, neoplasms of this kind appear more often than in representatives of other races.
• Premature babies are included in the so-called risk group. According to scientists, than less weight child at birth, the higher the likelihood of such a vascular anomaly.
• The age of the woman in labor increases the risk of the disease (the older the woman, the higher the likelihood).
• Chorionic villus biopsy does not play a significant role in the immediate formation of most hemangiomas.

Natural development

According to experts, the proliferation phase can last about five months. During the first 180 days, the vascular neoplasm reaches 80% of its final size.

Superficial hemangiomas in children grow several times faster than deep ones. The final phase of proliferation is often combined with the beginning of involution. The stage of reverse development is characterized by a change in the color of the skin in the affected area from pink to white.

Early appearance of light areas (before 3 months) is most often a sign of ulceration, but not involution. In 50% of cases, the stage of reverse development ends by the age of 5, in 70% of children the tumor goes away by the age of seven, and in 90% of young patients by the age of 9. Final involution does not mean that the skin on the affected area will become indistinguishable from healthy areas. In some cases, scars and minor cosmetic defects remain. Thus, it becomes clear that it is impossible to get rid of such a pathology as hemangioma in children without a single trace. Photos in specialized medical reference books clearly prove this statement.

Classification

• Simple hemangiomas are formed exclusively from capillaries. They are usually reddish or bluish in color. Most often, simple vascular neoplasms are located on the skin, covering literally a few millimeters of the so-called subcutaneous fat layer. Such spots have clear boundaries, have a smooth surface and only protrude slightly above the skin.
• Cavernous hemangiomas form under the skin and look like nodular formations. Tumors mainly consist of so-called cavities. They are cavities different sizes which are filled with blood. On initial stage education is no different normal color skin. As the disease progresses, it becomes purple in color. The skin above it feels slightly hotter than in other areas.
• Combined hemangiomas in children combine simple and cavernous types.
• Mixed variants are formed from tumor cells of different tissues, so their names may differ slightly (angioneuroma, angiofibroma, hemlymphangioma, etc.). Taking into account the fact from which tissue the tumor was formed, its consistency, color and even appearance are determined.

In any case, vascular formation - regardless of the type - requires competent treatment. Only qualified specialist will be able to after diagnostic examination recommend therapy, and, if necessary, perform surgery to get rid of a problem such as hemangioma.

Causes

In children, this pathology very often develops at a rapid pace. Unfortunately, at present doctors cannot name the exact reasons that lead to this problem. However, long-term observations and statistical data allow us to make several assumptions.

Taking into account the fact that the tumor appears in children early age, most likely, the reason lies in disorders that occur during intrauterine development. This and the reception of some groups medicines, and poor ecology, and suffered by a woman during pregnancy various diseases. Some doctors suspect that hemangiomas in children appear due to certain disorders at the endocrine level.

How does this pathology manifest itself?

Previously, doctors believed that hemangiomas do not appear in newborn children; their first signs appear before the age of three months. However, recently, more and more often pathological condition diagnosed specifically in infants. Pediatricians cannot explain this trend. It is suggested that the environment is deteriorating year by year and is to blame.

Hemangioma in a newborn baby looks like a small speck of a reddish or bluish tint. Most often, this pathology in the initial stages of its development is not recognized as a vascular tumor. Parents begin to treat the affected area with various anti-inflammatory ointments. However, such a speck does not stop growing, and after some time it completely changes its color. It is at this stage that parents begin to sound the alarm.

A superficial hemangioma on a child’s head, for example, does not have any special manifestations other than external ones. Vascular neoplasms located under the skin may have different symptoms.

Where is the tumor most often located?

The first place in the frequency of occurrence is occupied by the head area. There are also cases where a hemangioma appeared on a child’s lip, in the eyelid area, forehead, on the tip of the nose or on the cheeks. The second most common lesion is the genital area. Constant friction with diapers and clothes, contamination of this area with urine and feces - all this can lead to ulceration of the tumor and subsequent infection.

Diagnostics

Most often, hemangiomas in children are not visible at birth and may not be detected for several months. However, after some time, the development of the tumor becomes more obvious. To confirm the diagnosis, a visual examination is sufficient without any additional tests.

If the doctor is in doubt about the diagnosis, it may be necessary ultrasonography, MRI and CT scan. In particularly serious cases, the doctor will prescribe a biopsy.

Is special treatment required?

According to available data, about 10% of hemangiomas can lead to various kinds of complications throughout the child’s life. Exactly like this unpleasant consequences, as a rule, are a kind of impetus to seek help from a doctor.

Often the main indication for treatment is psychological condition parents and the child himself. As is known, the reverse development of these neoplasms can take several years, and if they are still in the open, this can cause a lot of inconvenience for a small patient. One cannot underestimate the conflicts that arise in this case, the consistently developing depression, and withdrawal into oneself. For example, a hemangioma on a child’s lip can lead to the development of complexes. Classmates begin to tease, friends turn away, afraid of getting infected.

The statement of doctors that vascular tumors must be treated from the moment they appear is not indisputable. The so-called wait-and-see approach is still common among many specialists, when they hope that the hemangioma will undergo involution. The need for treatment is confirmed only when primary complications appear. As a result, time is wasted, and the disease only continues to progress.

How is therapy different?

How to get rid of such a problem as hemangioma in children? In any case, treatment is determined by the doctor himself, taking into account several factors simultaneously (stage of the disease, age of the child, etc.). Below we list common methods of dealing with this problem.

How is laser removal of vascular tumors different?

Currently, laser removal of vascular tumors is considered one of the most effective methods of combating such a problem as hemangioma in children. Treatment with this method has many advantages. Its main advantage is that through this procedure it is possible to remove all forms of pathology and at any stage of development. In addition, therapy can be divided into several stages. Laser exposure It is not painful, but if discomfort occurs, you can resort to special pain-relieving ointments or creams. After completing the treatment course, it is important to wait from two to approximately six weeks until the symptoms disappear completely. inflammatory reaction. In some cases, a single intervention is enough to completely overcome this pathology. Of course, as with any other treatment method, complications may arise. According to experts, the percentage of such negative consequences still several times lower compared to the methods described above.

Where to remove a hemangioma for a child? In this case, it is recommended to seek help only from specialized medical centers where qualified doctors with appropriate licenses work. You should not try to cure the disease yourself. You can only harm the child, and meanwhile the pathology will only progress.

Why are such tumors dangerous?

• Ulceration is the most common complication, which is typical for tumors accompanied by violent growth. In this case, there is a high probability of secondary infection.
• Respiratory dysfunction. This problem is usually observed with hemangiomas in the neck area.
• Bleeding very often frightens young patients and their parents, however, simple cauterization this area skin allows you to solve this problem.
• Visual impairment occurs with hemangiomas in the eye area.

Conclusion

In conclusion, it should be noted once again that the optimal solution for getting rid of a vascular tumor is its removal. Hemangioma in children is certainly a rather serious pathology. However, if parents accept everything in a timely manner necessary measures, the child will not have to be embarrassed about his appearance or worry about his health in the future.

Today, operations to remove hemangiomas are among the most common. In this way, part of the vascular tumor, or the entire formation, is removed. During the operation, skin grafting is also performed.

For any location of hemangioma, surgical intervention is possible. However, cosmetic and functional disorders.

Surgical intervention is the simplest and quick way getting rid of hemangioma. During surgery, the entire tumor is removed at once. But in cases where the germination is too deep, then the removal will take place in several stages until the entire hemangioma is removed.

Surgeries on different parts of the body

If the hemangioma is on the face, then there are some indications for its removal. Therefore, cryotherapy should be performed first. Even if the operation is scheduled for a child, you should not worry about his age, because all the talk about possible bleeding is exaggerated. Experienced doctor can always stop heavy bleeding. Although it occurs only in cases where the removal extends beyond the boundaries of healthy tissue, that is, within the tumor. And this is exactly the case when it happens partial removal. At this moment, the assistant surgeon should press the tissues that surround the tumor.

If the hemangioma is located in the area of ​​the parotid gland and is an extensive formation, then removal can occur with little difficulty. During the removal process it may be affected facial nerve or the excretory duct of the parotid gland. To prevent this from happening, an experienced surgeon will perform the operation in a certain way. But, unfortunately, even this does not help all patients. Because tumor growth varies, and if it has covered almost the entire nerve, then removal will be impossible without affecting it. In such cases, partial removal is used, and the remaining part is treated using the sclerosing method.

Even if the size of the hemangioma is too large, it still surgery relevant. However, to correct the defect, skin grafting should be performed.

This helps a lot if the size of the hemangioma is too large and the area affected by it is the head, eyelids or joints.

When hemangioma surgery is performed on a child, a blood transfusion should be used at the same time.

If a child is diagnosed with a large and branched hemangioma on the extremities, then, unfortunately, there are problems associated with its removal. Because there is still no radical treatment. To remove such a formation, the doctor needs to perform surgery several times or resort to combined treatment. During removal, the doctor must make large incisions in order to clearly understand how damaged the tissue is and, if possible, remove this tumor as much as possible.

If the hemangioma of the limb is very large and covers most of it, then even amputation is possible. But before this, it is necessary to conduct a full examination and compare all factors. It is necessary to fully ensure that the treatment will not lead to positive results. Observe the tumor to see if it is constantly increasing. Also one of the factors is that the limb has lost its functionality. And, of course, constant incessant pain. All these factors are present in patients who systematically suffer from hemangioma. Also, in addition to soft tissue damage, bone damage occurs.

Consequences of surgery

The consequences are almost always positive. Because in most cases it is benign formations. However, if the hemangioma was not completely removed, a relapse of the disease may occur. In this case, a new operation or mixed treatment will be required.

Hemangioma is a benign growth of vascular tissue. Externally, such a formation resembles a tumor with a flat or lumpy surface of a reddish, purple or bluish tint. Most often, such growths occur in children, although they can also appear in adults. In newborns, such tumors usually result from developmental disorders. blood vessels in the prenatal period.

Hemangioma usually does not pose a threat to health and has no severe symptoms. It usually goes away on its own over time. However, a tumor can appear not only on skin, but also on internal organs and lead to their compression. Also dangerous are formations located near auricle, since when they grow they can injure the eardrum.

Specialists medical center"SanMedExpert" removes simple and cavernous (subcutaneous) hemangiomas using safe modern methods. It is advisable to remove the tumor for aesthetic purposes, as well as to prevent bleeding in case of accidental injury.

Indications for hemangioma removal

• at large sizes tumors;
• with a high risk of complications;
• in case of damage and bleeding of the tumor;
• when the tumor is localized in the area of ​​the organs of vision and hearing;
• if you want to get rid of the expressed cosmetic defect;
• For children, hemangiomas are recommended to be removed if they do not disappear on their own before the age of seven.

Radio wave surgery

Removal of hemangioma using radio waves is the most progressive and effective method treatment, especially if we're talking about about the tumor big size. The SanMedExpert clinic uses a special radio wave knife, with the help of which ionizing radiation is supplied to the tumor, under the influence of which the tumor cells die. Healthy surrounding tissues remain intact.

The method is painless for the patient. For complete removal hemangiomas may require several sessions, which should be done on an outpatient basis. Each session takes about forty minutes.

Popular questions

At what age can a hemangioma be removed?

Answer: Treatment can begin at any age from the moment of its onset

How does she look?

Answer: Externally, the hemangioma resembles a slightly convex birthmark of red or bluish color, which turns pale when pressed. To the touch the tumor has more high temperature, how healthy tissue. If education has nerve endings, it may be painful.

Is it always necessary to remove the growth?

Answer: It is better to discuss this issue with. Often the tumor disappears without a trace with age without any treatment. If you notice that it has begun to grow and begin to cause discomfort, it is better to remove it.

How many sessions are needed to remove a hemangioma?

Answer: This depends on the size and depth of the tumor, as well as the chosen method of combating it. For example, if it is small in size, it can be completely removed after just one cryotherapy session.

Hemangioma is considered a vascular neoplasm and is often a congenital phenomenon. Removal of the hemangioma is considered desirable, since the neoplasm is not aesthetically pleasing and can quickly grow, causing complications. Medicine offers many methods for removing unwanted formations quickly, almost painlessly and with effective results.

Removal of hemangioma is the most justified and effective measure to eliminate the tumor once and for all.

What is hemangioma?

Skin hemangioma is one of the types of benign vascular formations, which in 30% of cases is congenital. The neoplasm is already present on the child’s body from birth or appears a few days later. During the first 6 months of life, the hemangioma actively develops and by the age of one year the growth stops, after which by the age of 5 or 7 it completely resolves. Hemangioma is safe for health, but there are cases when the tumor continues to grow in older age. Large tumor entails the gradual destruction of organic tissues, which causes a number of complications associated with disruption of organ function.

Types of hemangiomas

Externally, the neoplasm looks like a bright red spot, asymmetrical in shape, which is located on the skin, under the skin or on the surface of the mucous membranes, internal organs. By structure they are distinguished:

• capillary;
• cavernous;
• capillary-cavernous;
• cellular;
• intermuscular.

Removal of the hemangioma is justified because eliminates the risk of dangerous injury, emotional and physical discomfort, impact on neighboring organs.

5 reasons why you need to remove a hemangioma

Cause	Specification
Cosmetic	Red spots often appear on the face, neck, and décolleté, causing dissatisfaction with the appearance.
Discomfort	Hemangiomas cause inconvenience. They begin to itch, hurt and bleed with constant contact with clothing or when walking.
Blood loss	Develops as a result of injury to a red mole.
Organ dysfunction	Depending on its location, the tumor can make breathing difficult, impair vision, or block the flow of blood through the vessels. Liver hemangioma causes bleeding, which can only be eliminated by surgery.
Getting infected	Since the neoplasm is easy to catch and injure, bacteria or infections enter the wound, which provokes the appearance additional problems with health.

Methods for removing hemangioma

To eliminate the red tumor, clinics use the following methods:

• Drug treatment. The drug "Propranolol" is used. An effective way you can't name it, because complete cure occurs in 2% of cases.
• Classic surgical removal.
• Alternative methods or physical methods removal (laser, liquid nitrogen, electric current).

Surgery to remove hemangioma is more often used to eliminate pathology in internal organs.

Surgical treatment - a radical method

The operation to remove the formation is performed in in rare cases, which are associated with problems with the appearance of hemangioma on internal organs. The scientific name of the operation is excision of hemangioma. During excision, the surgeon will remove not only the tumor, but also up to 2 cm of nearby tissue. Before removing the formation surgically, the clinic takes measures to reduce its size. To do this, the patient takes a course of medications and undergoes radiation. Surgery Suitable for removing small lesions that do not necessarily need to be removed, but cause daily discomfort (on the back, feet, legs or arms). The downside is the pain of therapy, and therefore excision is performed under general anesthesia. The procedure requires post-operative care, scars remain. Surgically removed hemangiomas are sent to histological examination, which shows the nature of the tumor.

Alternative Methods

Cryodestruction

Cryodestruction of hemangioma - freezing with liquid nitrogen. This method removes formations up to 2 cm in size to avoid the formation of scars. The procedure takes a few minutes: thanks to liquid nitrogen (at a temperature of -196 degrees), the tumor tissue is frozen. It subsequently dies, and in its place is formed normal tissue. After the procedure is completed, the treated area is wiped with a solution of potassium permanganate. To completely get rid of the tumor, it will take up to 3 sessions with short breaks of 2-3 days.

Laser is an effective ally in the fight against hemangioma

The laser beam has deeply penetrating properties, which makes it possible to process small vessels, which are located at a depth of up to 4 mm. Laser cauterization is the only method that does not leave marks on the face or neck. The therapy process boils down to cauterizing the tumor with a laser within a couple of minutes. After the procedure, a dense crust forms, which will come off on its own after 2-3 weeks.

Sclerotherapy

Thanks to sclerotherapy, red spots are removed from large neoplasms and those located in places that are difficult to reach during other procedures: the area of ​​the oral mucosa or the parotid area. The essence comes down to the introduction of a sclerosant into the tumor tissue by a puncture, which provokes chemical burn, thereby destroying small vessels. After the procedure, scar tissue appears at the site of the spot. Sclerosant - 70% solution ethyl alcohol, which begins to act after 2 hours, forming swelling. Over the next 2 days, the hemangioma thickens and becomes painful. The procedure is very long - the effect is noticeable no earlier than after 3 months.

Structure of blood vessels Vascular formations amenable to laser treatment Types of lasers for vessel removal The mechanism of laser vessel removal Indications and contraindications for laser vessel removal Removal of blood vessels with laser: procedure	Side effects and complications of laser vessel removal Removal of blood vessels on the face Removal of dilated vessels on the legs Spider vein removal Removal of vascular network Removing Wine Stains Removal of hemangiomas

Removal of hemangiomas

Hemangiomas- These are benign vascular tumors formed by proliferating (growing) cells of various structures. There are congenital hemangiomas, with which a child is born, and infantile hemangiomas, which appear in the first weeks of life. Adult hemangiomas, which first appear in adults, differ from “children’s” hemangiomas in that they are borderline tumors prone to malignancy.

Hemangiomas are a very common pathology and occur in approximately 14% of children in the first year of life. During the first year, rapid tumor growth is observed; by the end of the child’s first year of life, some hemangiomas undergo reverse development, while the rest either remain the same size or continue to grow rapidly. By the age of 5, about half of the hemangiomas disappear on their own (spontaneously regress), but in the other half of the cases, scars remain in their place, represented by foci of fibrolipomatosis. The existence of scars in the future can lead to dysfunction of the organs on which they once were or form a cosmetic defect.

Complications of hemangiomas: ulceration, bleeding, infection, scarring, dysfunction of nearby organs.

The classification of hemangiomas is quite complex. Hemangiomas can be superficial (located within the skin) and visceral (located in internal organs). Hemangiomas are also classified according to the stage of development (progressive, maturing, regressing), and the nature of development (involuting and non-involuting), single and multiple.

Diagnosis of hemangiomas is made based on questioning about the time of tumor appearance, objective examination data, and, if necessary, additional research, such as Doppler ultrasound, MRI, computed tomography.

To determine the state of the hemangioma (proliferation or regression), various cellular markers are studied (fibroblast growth factor, vascular endothelial growth factor, tissue inhibitor of metalloproteinases, and others). In some cases, the presence of hemangioma is only one of the manifestations congenital syndromes. Correct diagnosis largely determines the success of patient treatment. Therapeutic tactics depend on the location of the hemangioma and its growth rate.

In many cases it is shown dynamic observation for hemangioma, taking into account the possibility of its spontaneous regression. If hemangioma is localized on the face, organ dysfunction develops, or complications develop (bleeding, ulceration, etc.), it is advisable to start treatment early.

Drug treatment: for rapidly growing hemangiomas, the use of high doses hormones - corticosteroids both systemically and locally into the tumor. The use of interferon, despite high efficiency, is sharply limited due to the frequent development of severe neurological disorders in children.

In some cases it is shown surgical removal hemangiomas, however, the localization of the hemangioma and the likelihood of developing a cosmetic defect from a postoperative scar should be taken into account.

Mechanical treatment methods such as compression (compression to prevent growth), ligation and embolization of the feeding vessel are currently not used due to their ineffectiveness and have only historical significance.

Currently, the leading treatment method is laser removal of hemangiomas. The treatment of choice for superficial hemangiomas is dye laser. The most famous and effective dye laser currently is the V Beam laser, produced by the American company Candela.

However, since its radiation penetrates to a depth of 1.2 mm, neodymium laser and IPL are used to treat deeper located hemangiomas. By individually selecting the laser mode, you can achieve good results, up to the complete disappearance of the hemangioma. But it should be understood that the effectiveness of treatment largely depends on the size and depth of the hemangioma.

Removal of hemangioma with laser

Laser removal of hemangioma is performed either under topical anesthesia or after regional anesthesia. In some cases, laser removal of hemangioma can be performed under anesthesia. Since anesthesia is almost always used, the procedure is relatively painless.

Removing a hemangioma with a laser involves using a certain number of laser flashes aimed at the hemangioma. The radiation generated by the laser is well absorbed by oxyhemoglobin located in the vessels of the hemangioma. Oxyhemoglobin, in turn, heats the vascular endothelium and causes its destruction. This leads to cessation of blood flow in the vessels, their subsequent “gluing”, and a decrease in the size of the hemangioma itself.

1 - Before laser exposure; 2 - During laser exposure; 3 - After laser exposure

At the end of the laser hemangioma removal procedure, an ointment is applied, usually panthenol or bepanten. Immediately after the procedure, purpura (small hemorrhages) develops in the area affected by the laser, which disappears after 7-10 days. The final effect is assessed after 3 weeks, after which the procedure can be repeated. The number of laser hemangioma removal procedures can range from 1 to 6-10. In the case of rapidly growing hemangiomas, the interval between laser therapy sessions can be reduced.