Surgical treatment of childhood hemangiomas

Abstract

Hemangiomas are the most common benign tumors of infancy. By the first year of life, hemangiomas occur at a rate of 12%. There are many terms used to describe these tumors, making confusing the diagnosis and management. The Mulliken & Glowacki classification comprises two principal categories, based on clinical history and endothelial characteristics: hemangiomas and vascular malformations. Hemangiomas show a rapid rate of neonatal growth followed by a phase of involution, while vascular malformations are present at birth, grow commensurately with the child, and do not have a tendency to regress. 90% of hemangiomas regress spontaneously by eight years of age. The remainder, especially those located near vital organs, nose, eyelids, etc., or those with tendency to bleed, will require therapy, which includes steroids, interferon, laser therapy, embolization or surgery to avoid cosmetic and functional sequelae. Our series comprises 70 patients that underwent surgery for hemangioma. 71% were located in the head and neck. The age range went from three months to 15 years at the time of surgery. A single procedure sufficed in 70% of the cases. Surgery provides good long term results with minimal morbidity and prevents progressive deformity of adyacent normal structures and/or untoward psychological effects in these small patients.