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Prognosis?
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The prognosis depends on the diagnosis.
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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. |
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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. |
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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. |
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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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