Every parent dreams of having a beautiful and healthy baby. But, unfortunately, already during intrauterine development, the baby can acquire a congenital defect. Hemangioma in newborns is one of the most common diseases and occurs in 10% of newborn babies.
A hemangioma is a benign tumor made up of small blood vessels. A hemangioma appears in a child immediately at birth or in the first month of life. The rapid growth of education is noted only in the first half of the year, in the future it stops increasing, and sometimes it can completely self-destruct.
Although hemangioma is a benign neoplasm, it, like any disease, can have complications. Therefore, as soon as you find a neoplasm on your child's body, immediately consult a doctor.
Causes of hemangiomas
Hemangioma is a congenital disease and is formed in utero. The exact cause of the development of hemangiomas has not been identified, but there is a theory of the mechanism of the formation of this formation.
When the fetus is exposed to unfavorable factors, the cells lining the inner wall of the vessel (endothelium) can get into any part of the child's body - on the skin, in the internal organs. A vascular tumor will form in the place of their bookmark.
Factors contributing to the development of hemangioma include:
- acute respiratory diseases suffered by a pregnant woman in the 1st trimester;
- high blood pressure in a pregnant woman (eclampsia), which causes oxygen deprivation of the baby;
- hypoxia of the fetal brain;
- intoxicating effects on the fetus (taking medications, alcohol, smoking);
- the occurrence of Rh-conflict in the mother and fetus;
- the age of the woman in labor is over 35 years old;
- prematurity of the newborn;
- hormonal disorders during pregnancy;
- influence of harmful environmental factors;
- burden of heredity for the development of hemangiomas.
Classification of hemangiomas
There are several classifications that divide a large variety of hemangiomas into groups. Further treatment tactics and possible complications depend on the type of hemangioma.
Depending on the localization, hemangiomas are divided into three main groups:
- Cutaneous hemangiomas. The formation is localized in the surface layers of the skin.
- Hemangiomas of parenchymal organs (brain, liver, pancreas, spleen, kidneys and others).
- Hemangiomas of the musculoskeletal system (muscles, joints and spine).
Morphological classification takes into account the structure of the structure of the hemangioma:
- Capillary (simple) hemangioma. Formed by capillaries, most often located on the surface of the skin. It is considered the most common and safest type of hemangiomas. Outwardly, it is a red spot on the skin surface; over time, the hemangioma most often becomes darker. During the growth period, the capillary hemangioma can protrude above the skin and have a bumpy surface.
- Cavernous hemangioma is a vascular tumor consisting of dilated capillaries, densely anastomosing (connecting) with each other. There are cavernous hemangiomas of various sizes, single or multiple. Limited and diffuse hemangiomas are also distinguished. Cavernous hemangiomas can be located on the surface of the skin, in the thickness of the subcutaneous tissue, as well as on internal organs with increased blood supply (kidneys, liver, brain).
- Combined hemangioma simultaneously consists of capillary and cavernous parts, therefore it can simultaneously occupy both the skin surface and subcutaneous tissue. The appearance and clinical course depends on the predominance of the capillary or cavernous component in the tumor.
- Mixed hemangioma combines elements of a vascular tumor with other types of tissue (connective, nervous, lymphoid). These include angioneuromas, angiofibromas and others. The appearance of the tumor and clinical manifestations are different, since they depend on the structure of the tissue and their relationship to each other. Many doctors prefer to consider this type of neoplasm as an independent pathology with features of a vascular tumor.
Clinical course
The clinical manifestations of hemangiomas are diverse and depend on the morphology, size of the formation, the depth of the tumor spread in the tissue, as well as on the localization of the neoplasm.
Hemangioma in a newborn
It can be localized on any part of the skin - on the head, trunk, extremities, external genitals. On the skin at the site of the hemangioma, swelling and a reddening of the skin color are visible. With the predominance of arteries, the color of the formation is bright red, with a large number of venous vessels, the hemangioma has a dark color (cherry, burgundy).
With physical stress, an increased blood flow to the formation occurs, therefore, when the child cries, the hemangioma becomes bright in color and more swollen.
With pressure on the stained area of the skin, it turns pale, and after the cessation of squeezing, the hemangioma quickly takes on its usual appearance. If the lesion is located subcutaneously, the color of the skin may be normal.
To the touch, the hemangioma is dense or soft-elastic consistency. As a rule, dense formations are not characterized by an increase in size, but soft-elastic hemangiomas can give rise to rapid growth.
Sometimes with an increase in hemangioma in size, pain or sensory disturbances may be felt, this occurs due to compression of nerve fibers.
Hemangioma of the liver
Hemangioma of the liver in children is asymptomatic and, basically, is discovered by chance when performing an ultrasound of the abdominal cavity. To determine the structure and localization of the neoplasm, MRI of the liver is performed.
Hemangioma of the kidney
Hemangioma of the kidney is an extremely rare disease. This formation is congenital, but is often diagnosed later. During the active growth of the child, education also begins to grow rapidly, squeezing the surrounding tissues of the organ. Kidney function is impaired, resulting in clinical symptoms.
Kidney hemangioma is characterized by the following manifestations:
- pain in the lumbar region, radiating to the groin;
- renal colic;
- uncontrolled increase in blood pressure;
- the appearance of blood in the urine;
- increased body temperature;
- general lethargy and weakness of the child.
A small tumor may be asymptomatic. If a hemangioma of the kidney is found, surgical treatment is indicated.
Spinal hemangioma
Hemangioma of the spine is clinically manifested by constant intense pain in the back, which cannot be stopped by pain relievers, massage and anti-inflammatory ointments.
Hemangioma can manifest itself clinically as an attack of osteochondrosis, and only upon examination is a neoplasm detected. In childhood, the disease is extremely rare. The diagnosis is confirmed by performing an MRI of the spinal column. Treatment tactics are selected individually.
Possible complications of hemangiomas
- one of the most common complications of skin hemangiomas is bleeding or ulceration of their surface. More often it occurs in formations subject to mechanical trauma;
- due to a violation of the blood supply, the development of trophic skin disorders around the hemangiomas is possible;
- special attention is paid to hemangiomas localized on the face and scalp, since they are very close to important organs. Formations in the area of the eyeballs, ears can compress organs, disrupting their functions. Hemangioma localized in the neck can compress the trachea and cause breathing problems;
- hemangiomas of internal organs can be complicated by profuse internal bleeding, up to hemorrhagic shock with a fatal outcome.
Treatment of hemangioma in children
Treatment of hemangiomas in children is challenging. Modern medicine knows a wide variety of treatment methods to eliminate hemangioma. The choice of treatment method depends on the size, location, structure, rate of growth of education, as well as on the state of health of the child.
Some methods are outdated and not used because of their danger (for example, X-ray therapy), and some are just beginning to be widely used in practice. Consider the most common methods of treating hemangiomas in modern medicine.
Surgery
Surgical treatment is a radical method of treatment, which consists in removing the pathological formation within healthy tissues. Surgical treatment is a quick and affordable way to completely remove hemangiomas in children at once, but it has its drawbacks.
The operation is performed for children only under general anesthesia in a stationary setting. The most formidable complication in the surgical removal of hemangiomas is profuse bleeding that is difficult to stop. In addition, inflammation of the postoperative wound is possible, as well as tumor recurrence. After the operation, a scar is formed, which leads to an unsatisfactory cosmetic effect.
Thus, surgical treatment is more often used for mature hemangiomas, which have ceased their growth and differentiation, localized mainly on parts of the body, where cosmeticity is not of great importance.
Electrocoagulation
Electrocoagulation - the use of high frequency electric current using special devices. At the point of contact of the tissues with the active electrode, coagulation occurs, which destroys the tissues. This method is very simple and effective, but it is used only for hemangiomas of small size (up to 0.5 cm in diameter), since a scar remains at the site of exposure to the current.
Removal of hemangiomas with a laser
With the help of special equipment, a laser sensor with a certain wavelength is applied to the surface of the hemangioma. As a result of the action of high temperatures, the pathological vascular formations collapse and are subsequently replaced by new healthy tissue.
Due to certain parameters of laser radiation, percutaneous coagulation of tumor vessels is carried out without damaging the surrounding tissues, which leads to a good cosmetic effect. This method can be used to remove hemangiomas anywhere on the body, even on the eyelids. The procedure has no age restrictions.
Laser removal of the formation does not require general anesthesia; it is enough to apply an anesthetic in the form of an ointment to the hemangioma site in advance. Laser therapy is effective only for small lesions (up to 0.5 cm), and requires repeated exposure until the tumor is completely eliminated.
Cryotherapy
Cryotherapy is the use of cold effects on education. Liquid nitrogen is used as a cryoagent. Cryosurgery allows you to completely destroy a vascular tumor without damaging the surrounding tissue.
Cryotherapy is an effective treatment for rapidly growing capillary hemangiomas, but not all hemangiomas are subject to cold exposure.
Sclerotherapy
This is a treatment with chemicals that cause aseptic inflammation in the hemangioma and thrombosis of the vessels, as a result of which the hemangioma "empties" and is replaced by connective tissue. Sclerosants are injected into the area of the hemangioma.
With a large hemangioma, it is dangerous to inject a large amount of a sclerosing substance, this can lead to ulceration of the skin with the formation of a scar.
Previously, a solution of 70% alcohol was widely used. Currently, there are modern chemical sclerosing drugs. Sclerotherapy for hemangiomas is used for small vascular tumors of complex anatomical localization (in the region of the nose, eyelids, auricle, in the oral cavity).
A single injection of sclerosant is not enough, sometimes a long multiple course of injections is required. Also, the insufficiency of the method is the painfulness of the injection.
Hormone therapy
There are several options for hormonal treatment of hemangiomas. The most commonly used corticosteroid therapy is prednisolone. When prednisolone is used in the intervascular connective tissue and in the vessel wall, increased collagen formation occurs. The connective tissue compresses the vessels, disrupting their patency, the capillaries undergo atrophy and neglect.
With hormonal exposure, there is a slowdown or complete cessation of the growth of education. Hemangiomas respond especially well to hormone therapy in the first year of life. Hormone therapy is used most often as an auxiliary method of treatment.
Use of β-blockers
Recently, β-blocker therapy has become widespread for the treatment of volumetric hemangiomas of the face and trunk, as well as hemangiomas of internal organs. Treatment with these drugs is carried out under the strict supervision of a pediatric surgeon, pediatrician and cardiologist. The pediatric surgeon calculates the dose of the drug depending on the age and body weight of the child, several courses are carried out until the tumor is completely desolate.
Treatment is carried out under the control of hemodynamic parameters (pulse, blood pressure), since β-blockers affect not only the hemangioma vessels. Only a medical institution can provide treatment with this group of drugs. having permission for this type of activity.
Combined treatment
Combination treatment - a combination of two or more methods of hemangioma treatment at the same time, or sequentially one after the other. It is used in difficult cases, when using one technique it is impossible to achieve a complete cure of hemangioma, or in case of tumor recurrence.
Conclusion
If a speck or tumor-like formation is found on the child's body, it is necessary to contact a pediatric surgeon who will choose the optimal method of treatment in this case. Parents should be prepared for the fact that after removal of the hemangioma, cicatricial changes may remain, but this is incomparable with the harm that a tumor can cause.
Timely start of treatment and the correct choice of method allow not only to quickly heal the child, but also to prevent the development of possible complications.
