It is very important to make the appropriate
diagnostic work-up in order to decide upon the
appropriate treatment method. A dedicated and
well-trained physician is a must in order to
make the accurate diagnosis and treatment. It
is very common to see patients who have been
misdiagnosed and mistreated (or untreated) for
years (50% or higher).
If the lesion (tumor) is Infantile
Hemangioma, there is no need for treatment but
close regular follow-ups are necessary to rule
out tumor related problems (e.g., compression of
the airway) or skin breakdown. In some patients,
medical intervention may be indicated (using
steroids either systemically or intralesional
injections, or interferon). The tumor should
gradually regress with steroids. Please click here
for further information on treatment
strategies for infantile hemangiomas.
If the diagnosis of Kaposiform
Hemangioendothelioma (KHE) is made, more
aggressive follow-ups (particularly regular
check ups for platelets) and pharmacological
treatment are needed. If the patient develops
Kasabach-Merritt syndrome transcatheter
embolization is the ideal treatment, although
some small tumors may be removed surgically.
malformation (or cavernous hemangioma)
lesions can be treated
Depending on the size of the venous malformation
sessions may be needed. Surgical removal of
venous malformation is feasible for small focal lesions. Most
patients describe "growing back"
following surgery, and surgery may cause large
tissue necrosis and scars. Venous malformations
("cavernous hemangioma") generally respond
well to sclerotherapy (up to 70-80%).
malformations or cystic hygroma lesions can also be
treated by sclerotherapy, particularly
macrocystic (cystic hygroma) and mixed form
lymphatic malformations. Microcystic lymphatic
malformations can only be treated with surgical excision (if
possible). Radiofrequency ablation can be used
in selected cases.
Klippel-Trenaunay syndrome is usually managed
conservatively. Superficial varicoid veins can
be sclerosed or removed surgically, but it is
very important to check the patency of the deep
venous system in these patients. Parkes
syndrome is generally approached in a similar
manner to AVM lesions. Other combined anomalies are
also managed conservatively in most cases, and
intervention (either surgical or transcatheter
such as sclerotherapy or embolization) is used
in selected patients if needed.