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Cavernous Hemangioma - Definition, Causes, Symptoms and Treatment

 

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Cavernous hemangioma is the most common benign orbital tumor found in adults. Hemangiomas are usually present at birth, although they may appear within a few months after birth, often beginning at a site that has appeared slightly dusky or differently colored than the surrounding tissue. Most of these tumefactions are exceedingly unilateral. Although cavernous hemangiomas are histologically benign, they can encroach on intraorbital or adjacent structures and can be considered anatomically or positionally malignant. Visual acuity or field compromise, diplopia, and extraocular muscle or pupillary dysfunction can result from compression of intraorbital contents by the angioma. Hemangiomas may be present anywhere on the body. However, they are most disturbing to parents when they are on the infant's face or head. Hemangiomas of the eyelid may interfere with the development of normal vision and must be treated in the first few months of life. Large cavernous hemangiomas may develop secondary infections and ulcerate. Bleeding is common and may be significant following injury to the hemangioma.

Cavernous hemangioma is a vascular tumor, which contains stagnant blood. If the tumor causes compression of the optic nerve with associated peripheral vision loss or other signs of optic nerve compromise, the tumor must usually be excised. The nature and severity of the symptoms depend on the lesion's location in the brain. Cavernous hemangiomata can vary in size and be as large as several centimeters. The margins of the tumors are usually well-defined. Hemangiomata are filled with vascular channels of various sizes and also contain fibrous tissue. Rarely, patients with hemangiomata will present with anemia or low platelet counts because red blood cells or platelets are sequestered and destroyed in the tumor. Very rarely, a hemangioma can rupture, usually after abdominal trauma. Small cavernous hemangiomas situated on the surface of the body may be removed or treated by electrocoagulation. Surgery is usually needed if a cavernous hemangioma causes increased growth of an extremity.

Causes of Cavernous hemangioma

Cavernous hemangiomas may be present anywhere on the body. However, they are most disturbing to parents when they are on the infant's face or head. Hemangiomas are found on at least one in fifty babies. They tend to run in families. Large cavernous hemangiomas may develop secondary infections and ulcerate. Bleeding is common and may be significant following injury to the hemangioma. Girls are more likely to have hemangiomas than boys. They are also more common in babies with lighter skin coloring.

Signs and Symptoms of Cavernous hemangioma

Most hemangiomas grow rapidly, doubling their size, and then plateau for a while before collapsing and disappearing. Depending on their location, some hemangiomas may interfere with the growth and function of structures nearby, or may be associated with additional hemangiomas or other problems affecting internal organs. Large and rapidly growing hemangiomas may lead to ulceration, scarring, and disfigurement. When the color becomes dull, or the center appears gray or pinkish-gray, the hemangioma may be entering the slow disappearing phase.

Sign and symptoms may include the following :

  • A red to reddish-purple, raised lesion on the skin.
  • Psychosocial problems.
  • A massive, raised tumor with blood vessels.
  • Bleeding.

Treatment for Cavernous hemangioma

The great majority of hemangiomas will disappear on their own. Cavernous hemangiomas that involve the eyelid and obstruct vision are generally treated with injections of steroids or laser treatments that rapidly reduce the size of the lesions, allowing normal vision to develop. Large cavernous hemangiomas or mixed hemangiomas are treated, when appropriate, with oral steroids and injections of steroids directly into the hemangioma. When treatment is desired (for instance, when the hemangioma interferes with vision or feeding), there are several options available. Medicines and laser therapy have both been used with success.

Treatment may include:

  • Cavernous hemangiomas that involve the eyelid and obstruct vision are generally treated with injections of steroids or laser treatments that rapidly reduce the size of the lesions, allowing normal vision to develop.
  • Large cavernous hemangiomas or mixed hemangiomas are treated, when appropriate, with oral steroids and injections of steroids directly into the hemangioma.
  • Lasers may be used to reduce the bulk of the hemangiomas.
  • Some physicians are using a combination of steroid injection and laser therapy together.
  • Medications for heart failure may be needed.