Hemangiomas and vascular malformations: current theory and management

Abstract

Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumor. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. This paper reviews current theory and practice in the etiology, diagnosis, and treatment of these more common vascular anomalies.

Figure 1

(a) Proliferating hemangioma at 3 months of age. (b) Same hemangioma at involution at 4 years of age.

Figure 2

(a) Segmental hemangioma in trigeminal (V3) distribution. (b) Same hemangioma after 2 months of therapy with propranolol (2 mg/kg divided tid).

Figure 3

(a) Macrocystic lymphatic malformation (LM) of right neck in toddler. (b) Microcystic lip LM displaying mucosal vesicles. (c) Microcystic LM in older patient with bone involvement and mandibular hypertrophy.

Figure 4

Capillary malformation (port wine stain) of the left face in infant.

Figure 5

Cervicofacial venous malformation involving the right neck (a) and oropharyngeal mucosa (b).

Figure 6

Evidence of skin involvement in limb AVM. Patchy erythematous areas are palpably warmer and pulsatile relative to adjacent skin.