Overview of Vascular Anomalies in Children
Vascular anomalies in children range from easily treatable conditions such as port-wine stains to very complex conditions that may be challenging to treat.
The two major forms of vascular anomalies are vascular tumors (growths) and vascular malformations.
Vascular tumors are often seen at birth or in the first few weeks of life.
A hemangioma is the most common benign (noncancerous) tumor of the skin. Hemangiomas may be present at birth (faint red mark) or may appear in the first weeks after birth. Most hemangiomas occur in the head or neck area. Hemangiomas occur five times more often in females than in males. The cause of hemangiomas is unknown.
- Treatments may include medications such as propranolol or steroids, and/or laser treatments.
Vascular malformations may be made up of arteries, veins, capillaries, or lymphatic vessels and/or may be a combinations of various vessels (such as an arteriovenous malformation or venolymphatic malformation).
These malformations are often noted during the first year of life or during periods of rapid growth of the child, whereas the malformation may also enlarge. Vascular malformations do not resolve on their own but can be treated with various surgical modalities (lasers) or interventional radiology procedures (sclerotherapy or embolization).
Venous malformations (VMs) are caused by wide, abnormally-shaped veins. They cause soft, dark red to deep blue bulges on the skin. VMs are typically not curable and, over time, the malformations can grow. However, VMs can be treated by using interventional radiology (IR) procedures using injections of sclerosing agents.
- Complications may include: Pain, swelling, disfigurement, bleeding and blood-clotting problems.
- Treatments may include: Compression garments, interventional radiology (IR), surgery to remove the lesion, plastic and reconstructive surgery.
Lymphatic malformations (LMs) are soft tissue masses made up of lymphatic vessels. The lymphatic system clears lymphatic fluid from small blood vessels. The malformation causes this liquid to collect in the soft tissues. These malformations are often softball-sized and can go deep into the skin, making LMs difficult to treat. In some cases, LMs can result in small, clear bubbles on the skin (vesicles).
- Complications may include: Disfigurement, leakage of lymphatic fluid, bleeding and infections. In severe cases, LMs may cause bone disfigurement and difficulty breathing.
- Treatments may include: Interventional radiology (IR) with injections of sclerosing agents to reduce swelling. Surgery may be needed to remove the growth. In some cases, plastic or reconstructive surgery may be needed. Laser treatments can be helpful.
Arteriovenous malformations (AVMs) are a tangle of veins and arteries that are present at birth or develop in childhood. When AVMs are visible on the skin, they appear as discolored, blood-filled masses that pulsate and are warm to the touch. The cause of AVMs is unknown.
- Treatments may include: Interventional radiology (IR) procedures to inject sclerosing agents and embolization therapy. In some cases, surgical removal and follow-up reconstructive surgery may be needed.
A port-wine stain is a flat pink, red, or purple mark appearing at birth, often on the face, arms or legs. Port-wine stains do not go away and are often treated with multiple laser treatments. Port-wine stains involving the face may cause eye problems such as glaucoma.