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ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesInformation for PatientsView all Images (36)
Infantile hemangioma in Child
See also in: External and Internal Eye,Anogenital
Print
Other Resources UpToDate PubMed

Infantile hemangioma in Child

See also in: External and Internal Eye,Anogenital
Print Patient Handout Images (36)
Contributors: Maria Cordisco MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Hemangiomas are the most common tumor of childhood. They occur in up to 10% of infants. Female sex, prematurity, white skin, history of chorionic villus sampling, and prenatal factors such as older maternal age, maternal progesterone use, placenta previa, and preeclampsia are the risk factors for the development of hemangiomas. Superficial hemangiomas are noticed by 3 weeks of life. They have an initial proliferative phase lasting for about 3-6 months followed by a stage of regression (occurs at a rate of 10% per year) over a period of many years. They usually subside by 10 years of age, and they may leave behind some residual changes such as telangiectasia, scarring, atrophy, and fibrosis. Hemangiomas are usually solitary (focal), involving the head and neck region, but they may also be segmental or disseminated.

For more information, see OMIM.

Codes

ICD10CM:
D18.01 – Hemangioma of skin and subcutaneous tissue

SNOMEDCT:
83343001 – Infantile hemangioma

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Congenital hemangioma (CH) – Fully formed vascular tumors at birth; two types are described: rapidly involuting congenital hemangiomas (RICH) and non-involuting congenital hemangiomas (NICH). The proliferative phase in these tumors occurs in utero, and typically they do not proliferate postnatally as seen with infantile hemangiomas. CHs are characterized by hemispheric pink to purple vascular plaques with overlying telangiectasia and the characteristic peripheral rim of pallor. Both RICH and NICH may look similar; however, NICH is less impressive and flatter than RICH. Histologically, they are GLUT-1 negative, which helps to differentiate them from other hemangiomas.
  • Port-wine stain – Early lesions of hemangioma may be confused with port-wine stains, which are capillary malformations present at birth. They are pink or red patches that persist throughout life and do not have the typical growth phase of hemangiomas.
  • Sometimes tufted angioma and kaposiform hemangioendothelioma may mimic hemangiomas. They present as extensive brownish vascular plaques with deep fibrotic consistency.
  • Infantile myofibromatosis – Fibrohistiocytic proliferations characterized by skin-colored to purple, firm to hard or rubbery nodules that are usually present in the head and neck region.
  • Rhabdomyosarcoma – Soft tissue sarcoma of skeletal muscle origin typically seen in the first and second decades of life. In children, the head and neck areas are affected with an asymptomatic, rapidly growing, reddish cutaneous mass.
  • Deep hemangiomas sometimes look similar to venous malformations, which do not go through a phase of rapid proliferation. Phleboliths are often seen in venous malformations. Magnetic resonance (MR) imaging will help to differentiate these two entities.

Best Tests

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Therapy

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References

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Last Updated: 09/22/2017
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Infantile hemangioma in Child
See also in: External and Internal Eye,Anogenital
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Infantile hemangioma : Purple color, Tumor, Unilateral, Vascular plaque, Red
Clinical image of Infantile hemangioma
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