Pediatric Vascular Anomalies
Vascular anomalies refer to a variety of different conditions that are caused by the abnormal development of arteries, veins, and other blood vessels. They can include birthmarks, benign tumors (hemangiomas), and more serious malformations.
- Vascular anomalies can be grouped into two general categories: vascular tumors and vascular malformations. There are many different types of each.
- About one in every 10 children is born with a vascular tumor. The most common are hemangiomas, which usually do not require treatment.
- Vascular malformations are a more serious type of anomaly that usually requires some form of treatment. However, they are also much less common.
Vascular anomalies occur when a part of the vascular system, which is responsible for carrying blood, fails to develop normally. The most common cause is a random mutation. However, they can also be caused by an infection or injury. In rare cases, vascular anomalies may be the result of an inherited genetic defect.
The most common types of vascular anomalies are vascular tumors. Most are benign (they do not cause cancer) and can either be present at birth or appear in the first few months of life. They include the following:
- Angiosarcoma: A rare type of cancer that forms in the lining of the blood and lymph vessels. This type of tumor is often malignant.
- Glomangiomas: Benign clusters of glomus cells, which help regulate body temperature. They appear as purple nodules on the skin and can be painful.
- Hemangioendotheliomas: Abnormal growths of blood vessels. They may be benign or malignant.
- Hemangiomas: Abnormal growths of blood vessels that appear in the first few weeks of life, grow for about six months, then gradually recede. These are the most common type of vascular tumor. They are benign and usually do not require treatment.
- Kaposi’s Sarcoma: A type of cancer that forms in the lining of the blood and lymph vessels. It is characterized by purple spots (lesions) on the feet, legs, and arms.
- Pyogenic Granulomas: Small, round skin growths that are blood red or purple in color. They can bleed easily but are benign and can be removed.
Vascular malformations are a more serious type of anomaly. These are always present at birth, but may not become visible for a few months. They include the following:
- Arterial Malformations: Abnormalities in the arteries. This can be caused by dilated or overlapping arteries, and may slow or stop blood flow.
- Arteriovenous Malformations: Abnormalities in the connections between the arteries and veins. This can produce swollen areas of skin.
- Capillary Malformations: Also called port wine stains, these create patches of pink or purple skin due to permanently dilated capillaries.
- Complex Malformations: These include combinations of multiple malformations, such as abnormal capillaries, veins, and lymphatics (Klippel-Trenaunay syndrome), or both capillary and arteriovenous malformations (Parkes-Weber syndrome).
- Lymphatic Malformations: Abnormalities in the lymph vessels, which can produce water-filled cysts of varying sizes.
- Venous Malformations: Abnormalities in the veins, which can cause them to dilate and produce visible clusters of veins on the skin.
Symptoms will vary according to the type of vascular anomaly. However, the following are some common general symptoms:
- Obstruction of veins, arteries, lymph vessels, and/or capillaries
- Open sores and/or wounds
In most cases, vascular anomalies can be diagnosed through a review of a patient’s personal and family medical history, as well as a physical examination. The following are some additional diagnostic methods:
- Imaging Tests: These can help doctors gain a better view of an affected area to confirm a diagnosis. They may include a computerized tomography (CT) scan, an ultrasound, and magnetic resonance imaging (MRI).
- Biopsy: This is a surgical procedure that removes a tiny portion of tissue so that doctors can examine it under a microscope to determine what is wrong.
There are a variety of treatments available for vascular anomalies. Doctors will help patients and their families choose the best one depending on the type and severity of the anomaly. In many cases, particularly with vascular tumors, no treatment may be necessary.
The following are some of the most common treatment options:
- Cauterization: This involves applying heat to a specific part of the body to remove a growth or close a wound. It is typically used for small tumors on the surface of the skin.
- Medications: Vascular tumors such as hemangiomas often respond to medications such as corticosteroids and beta blockers. These can be given orally or topically.
- Laser Therapy: This uses lasers to destroy dilated capillaries and other vessels that may be causing discoloration or other abnormalities on the surface of the skin.
- Sclerotherapy: This involves injecting a liquid medicine into vascular and lymphatic malformations that first causes inflammation and then shrinkage.
- Surgery: For tumors that do not shrink and/or are located in areas that impede daily life (e.g., eyes or mouth), surgical removal may be necessary.
In general, with proper diagnosis and treatment, the long-term outlook for patients with vascular anomalies is good.
Vascular tumors will often recede on their own, which means no treatment will be necessary. If they do not, they can usually be treated with medication or minor surgery.
Vascular malformations do not recede on their own. Instead, they will grow progressively over time. However, if they do not present any symptoms, they will not require any treatment. If they do, then they can often be treated using medications, therapy, surgery, or some combination.
Our Pediatric Surgery program has extensive experience diagnosing and treating all forms of vascular anomalies. We can help treat and remove vascular tumors, as well as design personal treatment plans for more complex vascular malformations.
Call us at (212) 342-8585 or use our online form to schedule an appointment.