Prognosis?

 
       The prognosis depends on the diagnosis.
          
       Hemangiomas: Most infantile hemangiomas (tumoral vascular birthmarks) gradually involute (shrinking down) in early childhood without or with minimal residual scarring. Most hemangiomas that need to be treated with medication (steroids, inferferon, vincristine) respond well to pharmacological intervention. Although congenital hemangiomas appear more aggressive clinically and also on imaging studies, these lesions rapidly regress (usually much faster than infantile hemangiomas). Intramuscular hemangiomas and non-involuting hemangiomas are benign vascular anomalies/birthmarks, but usually require treatment (they do not involute). Kaposiform hemangiomas may cause significant health problems (e.g., bleeding) and need to be treated more aggressively (drug treatment, embolization, surgery etc.) and also require careful monitoring. 
        Low-flow vascular malformations (venous, lymphatic or cystic hygroma, lymphatic-venous, capillary malformations):  In general, low-flow vascular anomalies (birthmarks) such as venous malformations ("cavernous hemangiomas") and lymphatic malformations (cystic hygroma and similar lesions) are stable lesions, although most patients describe some degree of gradual enlargement. On the other hand, some low-flow anomalies, particularly lymphatic malformations may show rapid enlargement due to intralesional bleeding, which may cause significant problems in closed spaces (particularly in the eye socket causing optic nerve damage). Although these anomalies are generally considered benign acting vascular anomalies, they may cause significant symptomatology (e.g., pain, infection) that require treatment. Venous malformations and lymphatic malformations (particularly macrocystic lymphatic malformations) can be managed successfully with sclerotherapy.                                                                                                                         
        High-flow vascular malformations (arteriovenous malformation or AVM and arteriovenous fistula or AVF):  Arteriovenous malformations (AVM) usually progress and gradually involve more soft tissues, unless treated surgically or by embolization. AVM lesions usually need multiple embolization procedures, which generally make the lesion somewhat smaller and more importantly stable. Surgical removal of small AVM lesions can be curative. Arteriovenous fistulas (AVF) are usually stable lesions and generally respond well to embolization or surgical ligation.
 

Combined Anomalies (Klippel-Trenaunay, Proteus, Parkes-Weber, Maffucci): Combined anomalies, such as Klippel-Trenaunay syndrome, may or may not be stable and usually demonstrate mild or significant health problems (such as pulmonary embolism) depending on the extent of the vascular abnormality. 

 

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