hemangioma, cavernous

These tumors are benign by cell type but can have serious consequences. Cavernous hemangiomas are wild, jumbled growths of blood vessels fed by numerous tributary arteries (making surgical removal extraordinarily difficult and risky in most cases). They are probably all present at birth, but start to enlarge rapidly after delivery. They may attain great size and cause significant disfigurement or even impinge on vital organs or the airway.

Fortunately, these tumors have a life cycle. After rapidly enlarging for some months, they stabilize in size and then slowly begin to shrink of their own accord. Eventual complete or almost complete disappearance of these masses is the rule.

Aside from disfigurement and possible problems caused by sheer size of the birthmark, the tortuous blood vessel channels within the hemangioma cause the formation of platelet clots. These clots can consume platelets so rapidly that the bone marrow cannot keep up with production, and bleeding may develop elsewhere in the body because of severe reduction in the level of platelets in circulation.

Usually, the watchword with these things is wait patiently for them to go away by themselves. If complications force the issue and some sort of treatment must be attempted, oral steroids will often trigger shrinking of the hemangioma. This is the most common approach. More heroic measures include injection of tiny beads or other foreign material to clogg up the vessels, or as a last resort, surgery.

A word of caution: hemangiomas should be very soft and squishy to feel. They are blood vessel tumors, and are inherently soft. A hard, rubbery or woody feel to the tumor, even if it looks like a hemangioma, should raise suspicion that it is another type of tumor. The definitive procedure for diagnosis would be a biopsy in that case.

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