Hemangioma — signs, diagnosis, treatment
The main signs of pathology
The disease may be inherent or manifest after a few weeks. The peak of the disease development falls on the first six months from birth. Usually, the process of disease activity can subside. However, the cases are not excluded when the hemangioma continues to develop, increases in size and adversely affects healthy tissue, contributing to their destruction. A person experiences discomfort due to appearance and also suffers from dysfunction of internal organs and systems that have failed due to the progression of the disease.
*На фото гемангиома на лице новорожденного:*
Statistics show that this pathology occurs in 10% of newborns, and three times more often in girls. About 80% of all cases affect the face, hairy areas of the head and neck. The number of affected places is not always limited to 1 or 2 tumors, they can amount to several hundred. Their sizes also vary from 0.08 to 1 inch (0.2-2.5 cm) in diameter.
На фото опухоль на волосистой части головы:
As for adult patients, the discovery of such pathology is the cause of insufficiently effective treatment in infancy.
Фото взрослого пациента с гемангиомой:
Usually, hemangioma appears as a small formation, following the opposite path of development, disappears without a trace by the age of 5. This cannot be said about the vast affected areas.
Mechanism and causes of disease
Scientific researchers continue to work on for more accurate causes of pathology. So far, the destabilization of the fetal blood vessels formation is the only known reason which can be associated with.
At the theoretical level, there are several versions, the most reasoned are:
- Theory of lost cells.
- Slit (fissural).
The first is the assumption that the disease develops on the background of a violation of the capillaries and mesenchyme mechanism of development. At the end of the embryo formation process, the immature vascular tissues that are not turned into arteries and veins remain superfluous.
Under the influence of various factors, capillaries grow, without taking the necessary form, so they become the perfect material for tumors.
The fissural theory lies in the following presumption: on the 7th week, the embryo has room for the formation of the sense organs and the mouth. Capillaries and nerves penetrate these gaps to form facial organs. If the rudiments of blood vessels are observed to violate their further development, the hemangioma is formed on the face or head. This theory is reasoned enough, but in this case, the cause of the disease in other parts of the body remains unclear.
The latter theory, placental, is based on the assumption that placental cells enter the bloodstream of the embryo. Vascular tissue does not spread in the womb, due to the action of maternal factors of angiogenesis inhibition. This leads to the formation of the smallest capillaries. However, in the postembryonic period, placental cells that have entered the body receive freedom and can grow.
The mechanism of the appearance of the disease lies not only in the presence of undeveloped vascular embryonic tissue but also in the lack of oxygen, which is the starting point for the pathology onset. Scientists have concluded that the driving force is the factors that regulate the flow of oxygen to the fetus.
In addition, the disease contributes to:
- Multiple pregnancy.
- Placental insufficiency is a problem with the delivery of oxygen and other necessary substances to the embryo due to placental dysfunction.
- Birth injuries. The head of a newborn is sometimes severely compressed when passing through the birth canal, which disrupts blood circulation in the tissues. Rapid or prolonged parturition can serve as a provocateur factor for neoplasms.
- Eclampsia is a sharp increase in the blood pressure of the mother, leading to convulsions or fainting. This moment becomes the reason of insufficient intake of oxygen to the fetus.
- A smoking future mother condemns a future child to the occurrence of pathology. Tobacco smoke blocks the delivery of oxygen to the body, which adversely affects the state of the embryo. Hypoxia occurs, which contributes to the active growth of immature capillaries.
- Intoxication factors, such as harmful job, alcohol, drugs.
- The age of the pregnant. The riskiest period for pregnancy is after 40 years.
- Prematurity. Prematurely born children have often observed violations of the respiratory function, which leads to anomalies.
Classification and stages of hemangioma
The development of the disease is divided into the following stages:
- intensive growth can be observed during the first weeks after birth. The red tumor grows at a rate of 0.08 inch (2 mm) per day in all directions, including the depth. At this stage, there is a risk of complications in the form of a destructive effect for adjacent organs;
- when a child reaches 1 year of age the development of pathology usually stops;
- the reverse process: complete disappearance is observed only in 2% of patients.
Over the years, the neoplasm may become less noticeable, depending on the depth of germination. In some people, complete healing occurs, normal skin grows. For heavier forms, scars may remain.
Varieties of the disease regarding the structure:
- Simple (capillary) tumors are the most common (96% of cases). They have elevation under the skin surface, red or crimson pigmentation. Observed at the very beginning of the disease development.
- Cavernous occur at the moment when the capillaries are filled with blood, from which there is a rupture or hemorrhage. Formed cavities are filled with blood.
- Combined type appears as the moment of transition from the first type to the second. The body alternates the formation of immature vascular tissue and caverns.
- Racemose type can be observed on the limbs or scalp region of the head, accompanied by fistulas and vascular thickening.
- Mixed one is formed together with tumors of another kind: keratitis tumors, lymphomas.
By location in the human body the disease can be classified as follows:
- Skin hemangiomas are the most common (in 90% of patients), the number of them can vary from 1 to 100, they can be simple and cavernous.
- The internal organs lesion, inside the muscles, liver, and bones.
Diagnosis of the disease
Why is it so important to correctly diagnose the disease and start timely treatment? This need is based on the likely danger, despite the fact that the tumor is benign. If it is located on the internal organs, it can cause their dysfunction, which will lead to a serious deterioration of health and can be deadly. If it is formed on the face or head, it creates a huge discomfort in the mind of such a prominent cosmetic defect.
The surgeon, as well as other specialized specialists, is engaged in diagnosing.
The main diagnostic measures include:
- Medical examination.
- Research with the use of medical instruments.
- Delivery of tests for laboratory research.
- Consultation with specialized doctors.
At the first stage, the attending physician performs a visual inspection of the tumor and the adjacent parts of the body, examines the structure, texture, and response to palpation, measures the affected area. Next, he conducts a survey of the patient or his parents, ascertains such moments as the presence of such phenomena in parents and grandparents, whether treatment was carried out earlier and what effect was obtained.
Instrumental diagnosis includes:
- Thermometric type is conducted with the help of a thermocouple, which is able to establish ultra-precise body temperature of the affected and healthy areas. If the difference turns out to be 0.5 or 1 degree (at the affected place above), then the tumor is actively developing.
- Thermography is a procedure with infrared radiation, which allows determining the temperature in the context of the whole body. A heat map with red areas (increased temperature) and blue (normal temperature) are created. It is easy to determine the boundaries of the hemangioma, even if they have grown so deep that it is impossible to see them externally.
- Ultrasound can be used to obtain information about the presence of various tumors types (simple and cavernous), located on the skin and inside the body. This device can determine the structure, depth, size of the sore spot.
- Computer tomography is associated with radiation dose, therefore it is used in exceptional cases. This high-frequency method is able to diagnose the smallest formations.
- With the help of MRI doctor can obtain an accurate display of the soft tissues state. Also, this method does not bring harm to health. It is prohibited in the presence of metal implants in the body.
- Angiography is a method of data obtaining about the likelihood of damage to organs and tissues located next to the pathological formation.
- A biopsy is a microscopic examination of tissues. This method is shown in case of suspicion of the transition to a malignant form.
Laboratory methods include a general (expanded) blood test to determine the number of platelets, the presence of anemia.
As for the participation of consultants, oncologists, dermatologists, hematologists, infection specialists are involved in this.
Ways of treatment
Until recently, the main principle approach to treatment was waiting one. However, judging by the fact that only in 2% of cases there is a return path of development when the tumor disappears independently, the opinion of scientists has changed. Still, the sooner the treatment of hemangioma is started, the less the risk of complications.
Treatment can be carried out using such methods:
- Physical removal with laser irradiation, sclerotherapy, and other methods.
- The surgical method is applied in places such as legs, back, arms. The fact of a postoperative scar is taken into account.
- Therapy with the use of drugs, such as a vasoconstriction drug Propranolol, a hormonal steroid Prednisolone, an antitumor medication Vincristine.
Possible complications, prognosis and prevention
Ignoring the appearance of hemangioma on the body means to condemn a person to the next possible negative consequences:
- Damage to organs near the affected area.
- Dysfunction of the bone frame, muscle tissue.
- Paralysis due to the destruction compression of the spinal cord.
- Infection occurrence.
- Transition to malignant form.
- Unaesthetic appearance.
With timely treatment, correct diagnosis and the strict implementation of medical recommendations, getting rid of such an unpleasant disease is guaranteed.
The main tips are prevention. To understand what it is, it is enough to delve into the causes of this pathology and exclude those that depend on human behavior.