Hemangioma. Causes, symptoms, signs, diagnosis and treatment of pathology. Types of benign tumors in the lungs. Causes of hemangioma

Of the vascular formations of the lungs, the most common are hemangiomas - tumors consisting of anastomosing arteriovenous sinuses and cavities filled with blood. Lung hemangiomas are described in the literature under other names that characterize this type tumors as a developmental defect: “pulmonary arteriovenous aneurysms”, “varicose veins of the lung”. Despite the fact that these diseases are developmental defects, they are detected more often in older children or adults. Thus, J. Muri notes that out of 73 patients described in the literature, 11 were children under 15 years of age; 32 patients were older than this age; the ages of the others are not specified. Most observations relate to the male gender.

The localization of hemangiomas in the lung varies; most often they are located in the lung parenchyma itself. Hemangiomas are usually limited to lung tissue, however, in the literature there are descriptions of its growth from the lung into the chest wall. Lung hemangiomas are often multiple, affecting even both lungs. Sometimes they are combined with a malformation of blood vessels in the area of other organs and skin (telangiectasia). These manifestations are an indirect sign that facilitates the recognition of pulmonary hemangiomas.

Symptoms of hemangioma. Clinical manifestations depend on the size and location of hemangiomatous formations, as well as on the nature of arteriovenous fistulas. With a hemangioma that forms fistulas between the pulmonary artery and the pulmonary vein, i.e. directly between the great vessels, a hemodynamic disorder comes to the fore. A child with such a hemangioma experiences cyanosis, shortness of breath, weakness, frequent dizziness, and sometimes hemoptysis. Due to constant hypoxemia, the child is delayed in growth and development. Polycythemia gradually develops. Depending on the location of the tumor in the lung, you can sometimes hear a noise in lung vessels.

Hemangiomas that form vascular fistulas within segmental arteries and veins have little clinical manifestation; the most constant sign is a gradual increase in polycythemia over many years. Percussion and auscultation data do not allow us to determine the nature of the disease. No malignant degeneration is observed.

The X-ray picture depends on the size and presence of arteriovenous connection. Typically the tumor is ovoid or spherical in shape, often with irregular scalloped but fairly distinct edges. As a rule, it is determined increased density root of the lung, apparently due to an increase in the pulmonary artery and vein. Sometimes there is a direct connection between the formation and the large vessels of the root of the lung. When X-rayed, you can often see the pulsation of the tumor, which is independent and not transmitted (from the heart) in nature. During exhalation, the shadow of the hemangioma decreases, during inhalation it increases and becomes more intense. Angiography often determines the extent of the lesion and can detect small hemangiomas that are not detected by plain fluoroscopy.

Treatment only operational. It consists of removing the affected part of the lung; most often it is necessary to perform a lobectomy and even removal of the entire lung. For multiple hemangiomas localized in both lungs, resection should be economical; the most affected areas are removed.

Pathology in the lung is a cluster of anastomosing blood vessels measuring 0.4-8.5 cm in diameter ( average- 2.8 cm). It is most often formed in children after 6-7 years of age and in adults. Men are more susceptible to the disease than women. A pathological formation in the lung is characterized by a slow increase and clear boundaries separating the tumor from healthy surrounding tissues. Diagnose the problem using x-rays, computed tomography and ultrasound. Treatment is primarily through surgical removal.

Pulmonary hemangioma is often a genetically determined and rare disease of a non-malignant nature.

General information

Varieties

Capillary hemangiomas, found in 50% of cases, are divided into simple and hypertrophic.
Cavernous (cavernous).
Capillary-cavernous - mixed hemangiomas of the lungs, characterized by the largest size.

Intrapulmonary.
Endobronchial.
Central.
Peripheral.

Solid.
Papillary.
Hemorrhagic.
Alveolar.
Sclerotizing.

Capillary pulmonary hemangiomas occur in half of the cases of hemangiomas and consist of many small blood vessels. More often, this type of formation occurs in the lungs of children in the first 2 years of life. The tumor can grow deeper and penetrate the walls of important vessels and even the membranes of veins. Cavernous hemangiomas of the lungs are formed mainly from large vessels, and they are larger in size than capillary ones. Mixed type of pathology is the largest formation formed from different types tissues and vessels.

Doctors call UV rays, intrauterine developmental problems, and vascular pathologies as provocateurs of pulmonary hemangioma. Return to contents

Causes of pathology

According to histogenesis, pulmonary hemangioma is a dysontogenetic pathology, the basis of the formation of which is an intrauterine deviation in the formation of vascular tissues. This disorder is accompanied by the formation of an excess number of blood vessels. Due to the fact that the vascular lung tumor consists of endothelial cells (cells lining the internal vascular walls and characterized by the ability to multiply quickly); sharp accelerations in the growth of pathological neoplasms are possible. Until the end, medicine does not know the exact reasons for the formation of hemangiomas, and the probable causes include:

excessive exposure to ultraviolet radiation;
hereditary tendency;
diseases vascular system;
transferred by the mother in the embryonic period of development infectious diseases during which medications were taken.

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How does the disease manifest itself?

The course of the pathology depends on the morphological characteristics, place of formation and type of structure. Because of pathological formation in the lungs grows slowly over several years, then the primary symptoms of the tumor in 90% of cases are absent or vague. Appearance clinical symptoms possible with a significant increase in pathology and with accelerated growth of a benign tumor. The rapid growth of a pulmonary tumor is characterized by the following signs:

Lung hemangioma can cause problems with breathing, blood circulation, and well-being.

pressing pain in the chest area;
pulmonary hemorrhage;
frequent coughing up blood;
the formation of holes between the pulmonary artery and vein;
shortness of breath and heavy breathing;
cyanosis;
dizziness associated with a lack of oxygen in the blood.

A dangerous complication of a vascular tumor in the lung is the probable rupture of the tumor, which occurs after lung injuries, especially resulting from strong prolonged pressure. The result of injury is profuse blood loss, which leads to death. Abnormal growth of pathology in the lung causes compression of blood vessels and adjacent healthy tissue. It is possible to develop a lung abscess. Transition to a malignant course occurs no more than 1% of cases.

Diagnostic measures

Often, hemangioma in the lungs is discovered accidentally during scheduled inspection. Diagnosis of pulmonary pathology is made by a pulmonologist, who draws up a diagnostic history based on the patient’s symptoms. During the initial examination, while listening to the lungs with a stethoscope, noises are heard. Secondary symptom hemangiomas - expansion of small skin vessels and the appearance of spider veins that are not associated with inflammation (telangiectasia). Diagnostic methods:

Radiography. Visualizes a round or oval vascular formation, which is clearly limited from the surrounding tissues, and the border is often irregular in shape.
Computed tomography of the lungs. Determines the dilation of the vessels of the respiratory organ and the increased density of the pulmonary root. There are pulsating movements of the tumor that are not associated with respiratory movements.
Ultrasound examination with Dopplerography. An informative method for diagnosing vascular disorders, allowing one to calculate the volume of a neoplasm and its structure.
Bronchoscopy. Carry out with endobronchial enlargement of pathology.
Angiography of blood vessels. A method confirming the vascular nature of the hemangioma, the characteristics of its formation and the nature of its spread.
Biopsy. It is rarely performed to differentiate a hemangioma from a malignant tumor.

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Treatment of pulmonary hemangiomas

The main treatment method for benign pulmonary tumors is surgical removal by a thoracic surgeon. The surgeon cuts out the pathological formation from healthy tissue. If there is more than one tumor in the lungs, then the doctor performs an economical resection of the areas of the lung with the greatest damage. It is better to remove the tumor at an early stage of the disease, while the size is minimal, but since the early stage of the formation of the pathology is asymptomatic, they often learn about the disease when the size of the tumor is significantly increased. Depending on the affected area, the following types of pathology removal are distinguished:

fenestrated resection of the bronchus (circular removal);
segmental excision (marginal resection);
resection of the pulmonary lobe (lobectomy).

As a rule, surgical removal of pulmonary hemangioma provides an effective outcome from therapy.

Very rarely, doctors resort to complete removal of the lung or pneumonectomy. This method is chosen only in extreme cases when the lung cannot be saved. When the position of the hemangioma does not interfere with the organ’s ability to perform its work function and there is no tendency to grow, doctors choose a wait-and-see approach, especially for newborns and small children. Often a hemangioma forms unexpectedly and resolves on its own. Modern surgical methods and diagnostic procedures create a favorable prognosis for the treatment of pulmonary hemangioma.

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Hemangioma: symptoms, diagnosis, treatment in children

Benign neoplasms are quite common in childhood. Every tenth child under the age of one year is diagnosed with hemangioma. This is a benign tumor that originates from blood vessels. And although the process is benign, it is necessary to closely monitor the progression of hemangioma and begin treatment in a timely manner. IN otherwise one should be wary of the development of complications.

Hemangioma: causes of occurrence

To the question of why hemangioma develops, scientists still cannot give a definite answer. The probable cause is the impact of adverse factors during pregnancy during the development of fetal mesenchymal tissue. Blood vessels are formed from this tissue. Most aggressive unfavorable factor are infectious diseases of pregnant women, in particular ARVI.

They are often discovered literally immediately after the baby is born or in the first weeks or months of life;
Hemangiomas are more often recorded in girls;
Hemangiomas can be of completely different sizes: from a small dot to a large spot.

Development of hemangioma in children

A characteristic sign of hemangioma is a change in its size. There are three stages in the development of hemangioma:

Period of intensive growth;
Period of growth cessation;
Period of reverse development.

It is quite difficult to predict how actively the hemangioma will increase in size. Sometimes the tumor grows even several centimeters per week. It is reliably known that premature babies hemangiomas grow much faster than in full-term babies. Hemangiomas actively grow in the first months of a baby’s life. Once the child reaches six months of age, the growth of the neoplasm slows down. This stage is called the stunting period and lasts several years.

The further development of hemangioma is difficult to predict. Reverse development (regression) of the neoplasm often occurs. The brightness of the spot gradually decreases, areas of white. After six to eight months, the hemangioma becomes pale pink and smooth. By the third or fourth year of a child’s life, only an area of depigmentation on the skin reminds of a neoplasm. It is worth noting that regression is only possible in the case of simple hemangiomas. Cavernous and combined hemangiomas never regress.

Types of hemangiomas

Hemangiomas are most often localized on the skin, but can also occur in internal organs. There are the following types of hemangiomas:

Hemangioma on the skin

Hemangiomas have their own favorite places. Most often they occur in the face, scalp, neck, mouth, and hands. Much less often - on the external genitalia, legs.

Simple hemangiomas

In the structure of all hemangiomas, simple hemangiomas make up approximately 95%. A simple hemangioma is a layer of small, tightly adjacent capillary vessels. Sometimes the vessels gather into lobules. The lumen of the vessels is filled with blood. Simple hemangiomas are localized on the skin and do not penetrate the subcutaneous fat. The surface of capillary hemangiomas can be flat or nodular-lumpy.

A simple hemangioma looks like a raised red spot on the skin, which can be of varying sizes. If you press on the edge of the spot, you will notice how it gradually fades. This is due to compression of the vessel and expulsion of blood from it. But as soon as you let go of the skin, the spot immediately turns red. The spot has clear edges and is demarcated from the surrounding healthy tissue. There may be one or more of these growths on the skin.

Cavernous (cavernous) hemangiomas

Cavernous hemangioma consists of many cavities separated by septa. This type of hemangiomas is located in subcutaneous tissue. Cavernous hemangiomas account for about 3% of all hemangiomas.

Externally, cavernous hemangioma looks like extensive education, which rises noticeably above the skin. The surface of the formation is rough. The skin of cavernous hemangioma is not changed. But a bluish tumor-like formation is visualized under the skin. It has a soft elastic consistency to the touch. If you press on it, the swelling decreases somewhat. But soon it regains its previous form. It is typical that when a child strains, cries, or even coughs, the tumor briefly increases in size due to blood flow to it.

Mixed hemangiomas

Mixed hemangiomas are those that are combined with other neoplasms, such as lymphangioma or lipoma. Such hemangiomas are very rare, occurring in approximately 0.6% of all cases of hemangiomas.

The color, consistency, and appearance of the tumor will depend on the tissues that make up the tumor.

Combined hemangiomas

In the structure of all hemangiomas, combined hemangiomas make up only 2%, but they are the ones that pose the greatest difficulty in treatment. Combined hemangiomas have supracutaneous and subcutaneous parts. External manifestations will depend on which of the components of the hemangioma predominates: capillary or cavernous.

Complications

Hemangioma grows quite quickly, and it is very difficult to predict its further effect on the body. Among the main complications of hemangiomas are:

Bleeding. Develops when tumor tissue is injured. Bleeding with liver hemangioma is especially dangerous, since the volume of blood loss can be very massive.
Ulceration. It develops mainly when hemangioma is localized in the area of the lips, perineum, and large folds of skin. Characterized by the development of an ulcer at the site of the tumor.
Blood clotting disorder. This is due to the fact that a hemangioma, roughly speaking, is perceived by the body as a damaged vessel, which is why platelets actively flow into this area. Over time, the number of platelets in the blood decreases, which can lead to poor clotting blood.
Inflammation and suppuration. Often associated with trauma to the tumor.
Dysfunction of organs affected by hemangioma(impaired vision with hemangioma of the eyelid, impaired hearing with hemangioma of the ear).

Hemangioma of internal organs

Hemangioma can form in internal organs: brain, uterus, lungs, kidneys. The most common type is liver hemangioma. The tumor is usually solitary and small in size. Hemangiomas of the liver are simple (capillary) and cavernous. Capillary hemangiomas are usually small and do not exceed a few centimeters. Cavernous reach ten centimeters.

It is noteworthy that often the tumor does not cause any discomfort. This is how a person lives with an illness long time. Around the age of fifty, the size of the tumor increases and then symptoms of the disease begin to appear: dull pain in the right hypochondrium, nausea, flatulence, bowel dysfunction, jaundice.

Bone hemangioma

Bone hemangioma is a slow-growing benign tumor. More often the tumor is located in the spine, somewhat less often in the bones of the skull and pelvis, and tubular bones.

Bone hemangiomas are usually asymptomatic and are therefore discovered by chance during a routine examination. Only in 1-1.5% of all cases, bone hemangioma is accompanied by pain. Bone hemangiomas do not always require active treatment, but constant monitoring by a doctor is necessary. The thing is that an expanding hemangioma of the spine, for example, pushes the bone elements apart, which can cause vertebral fractures.

Diagnostics

A doctor may suspect a hemangioma during an external examination of the neoplasm. Firstly, the presence of a raised red spot testifies in favor of a hemangioma. Secondly, with hemangioma, the spot turns pale when pressure is applied to it and restores its shape and color after the pressure stops.

To confirm the diagnosis, as well as clarify the extent of skin damage, certain studies can be carried out:

Ultrasound is performed to study cavernous hemangiomas, as well as neoplasms of internal organs. This diagnostic method allows you to study the structure, depth, size of the hemangioma.

If hemangiomas of internal organs are suspected, computed tomography or magnetic resonance imaging is performed. These methods make it possible to detect tumors of the smallest size. In addition, only tomography can determine the presence of hemangiomas in the bones.

A clinical blood test is performed to determine complications and monitor the patient’s condition during the course of treatment. Characteristic changes in the blood with hemangiomas are a decrease in the number of platelets, and in addition, red blood cells with hemoglobin.

Treatment of hemangioma

Treatment issues must be approached individually, taking into account the specific course of the disease in specific child. You can often hear the opinion that hemangiomas do not need to be treated, because they can disappear on their own when the child grows up. However, this opinion is too frivolous. Indeed, simple hemangiomas can regress, but this does not happen in every case. In addition, cavernous and mixed hemangiomas are not at all capable of regressing. Thus, a wait-and-see strategy can only be applied in the case of simple uncomplicated hemangiomas with signs of regression.

There are certain indications according to which treatment of hemangioma should begin as soon as possible:

Hemangiomas located in the head and neck area, in the mouth, anogenital area;
Fast-growing tumors (its area doubles in a week);
Complicated hemangiomas.

Surgical treatment: removal of hemangiomas

Surgical excision of the skin of the tumor is a generally accepted treatment for hemangiomas. However, nowadays surgical intervention is rarely resorted to. First of all, due to the fact that surgical intervention must be carried out under general anesthesia. Surgical excision of the skin may be accompanied by blood loss, and a scar remains after the operation. However, surgical excision is preferred for deep hemangiomas, as well as for mature forms of the tumor. That is, when other treatment methods are impossible.

Removal of hemangiomas with laser, cryodestruction

Modern physical methods removal of hemangiomas (cryodestruction, laser removal) have many advantages compared to surgical treatment. Such manipulations are carried out on an outpatient basis, because the procedure lasts only minutes, and there is no need to administer anesthesia to the child.

During cryodestruction, the skin is exposed to liquid nitrogen at a low temperature. The method itself is quite simple, it does not require any special preparation and is carried out without anesthesia. Hemangiomas located on the skin are targeted with liquid nitrogen within seconds, hemangiomas on the mucous membranes - within 7-15 seconds. On the third or fourth day, a crust forms on the treated area of skin; after a month, complete healing of the skin occurs. For large hemangiomas, treatment is carried out in several stages.

Laser removal is successfully used in the fight against hemangiomas. This method is used for tumors with a diameter of up to two centimeters. The laser causes thermal destruction of the tumor. The advantages of the method are that the possibility of bleeding is eliminated, since the laser beam cauterizes the vessels. A crust forms in the affected area, which disappears after two to three weeks. In its place a small scar is exposed.

Conservative treatment

Hemangiomas can be treated conservatively. One of the methods used in the fight against cavernous and combined hemangiomas is sclerosing therapy. A sclerosing agent - 70% alcohol - is injected into the tumor. This leads to an inflammatory reaction and thrombosis of the vessel, due to which the blood supply to the hemangioma stops. Soon the hemangioma can regress. Typically, several repetitions of procedures are required to achieve the desired result.

It is also used in the fight against extensive hemangiomas. hormone therapy. For this purpose, the child is prescribed Prednisolone. By the end of hormonal therapy, the volume of the angioma decreases and growth stops; whitish areas of healthy skin appear on the surface of the hemangioma. If necessary, the course of hormonal therapy can be continued after one to two months. However, with the help of such treatment it will not be possible to achieve the desired cosmetic effect, that is, the complete disappearance of the hemangioma. Therefore, you will have to resort to other methods of treatment.

The beta blocker Propranolol can also be used in the treatment of hemangiomas. The drug leads to constriction of tumor vessels, stimulating replacement vascular wall scar tissue.

For angiomas with complex localization, for example, in the orbital area or occupying a fairly large area, radiation therapy is used.

In any case, the decision on the need for dynamic observation or active treatment is made by pediatric surgeon. Therefore, if your baby has a hemangioma, you should consult a doctor and not wait for self-healing.

Grigorova Valeria, medical observer

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Lung hemangioma - Tumors and cysts of the chest cavity in children

Lung hemangiomas, or vascular formations, consist of countless anastomosing arteriovenous vessels and cavities filled with blood. Lung hemangiomas are described in the literature under other names that characterize this type of tumor as a developmental defect: pulmonary arteriovenous aneurysms, varicose veins of the lung. Despite the fact that these formations are a developmental defect, they are detected more often in older children or adults. Thus, Muré (1953) notes that out of 73 patients described in the literature, 11 were children under 15 years of age. MikuJas et al. (1972) describe 2 patients with arteriovenous fistulas, one of them was a 7-year-old child.

The localization of hemangiomas in the lung varies; most often they are located in the lung parenchyma itself. Typically, hemangiomas are limited to the lung tissue, but in the literature there are descriptions of its growth from the lung into the chest. Lung hemangiomas are often multiple, affecting even both lungs. Sometimes they are combined with a malformation of blood vessels in the area of other organs and skin (telangiectasia). These manifestations are an indirect sign that facilitates the recognition of pulmonary hemangiomas.

Clinical manifestations depend on the size and location of hemangiomatous formations, as well as on the nature of arteriovenous fistulas. With hemangioma with fistulas between the pulmonary artery and pulmonary vein, i.e. directly between the great vessels, hemodynamic disorder comes first. A child with such a hemangioma experiences cyanosis, shortness of breath, weakness, frequent dizziness, and sometimes hemoptysis.

Depending on the location of the tumor in the lung, a vascular murmur can sometimes be heard.

Hemangiomas that form vascular fistulas within segmental arteries and veins have little clinical manifestation. The most consistent feature is a gradual increase in polycythemia over many years.

Percussion and auscultation data do not allow us to determine the nature of the disease. No malignant degeneration is observed. In some cases, small hemangiomas in the lungs are discovered by chance. Thus, I. G. Klimkovich and co-authors (1967) provide a description of a pulmonary hemangioma that was asymptomatic in a 4-year-old child.

The X-ray picture depends on the size of the hemangioma and the presence of an arteriovenous connection. Typically the tumor is ovoid or spherical in shape, often with irregular scalloped but fairly distinct edges. As a rule, an increased density of the lung root is determined, apparently due to an increase in the pulmonary artery and vein. Sometimes there is a direct connection between the formation and the vessels of the lung root. With transillumination and x-ray kymograms, it is possible to see the pulsation of the tumor, which is independent and not transmitted (from the heart) in nature. During exhalation, the shadow of the hemangioma decreases, during inhalation it increases and becomes more intense.

Angiography often determines the extent of the lesion and makes it possible to detect small hemangiomas that are not detected by plain fluoroscopy (E. N. Meshalkin, E. A. Damir, 1956).

Lung hemangioma

Pulmonary hemangioma is a rare benign tumor-like formation of the lungs, represented by a conglomerate of overgrown and anastomosing blood vessels. Symptoms of a tumor may include hemoptysis, chest pain, shortness of breath, cyanosis, weakness, and spontaneous pulmonary hemorrhage. The diagnosis of pulmonary hemangioma is based on data clinical picture, radiography and CT scan of the chest, angiography, bronchoscopy, ultrasound with Dopplerography of blood flow. Treatment of hemangioma is surgical, usually excision of the tumor, economical resection of the affected area of the lungs or bronchus, and lobectomy.

Lung hemangioma

Pulmonary hemangioma is an intrapulmonary or endobronchial vascular tumor of mesodermal origin with a benign course. Hemangiomas can develop in any organ, but are rarely detected in the lungs. In addition to hemangiomas, pulmonology also has to deal with other angiomas - hemangioendothelioma, hemangiopericytoma, lymphangioma, glomus tumor. Lung hemangiomas are characterized by clear demarcation from surrounding tissues, fairly slow growth and lack of tendency to malignancy. Vascular tumor of the lungs is more often detected in older children and adults, mainly males. Pulmonary hemangioma can be combined with another pathology of vascular development - telangiectasia of the skin and various organs.

Causes of pulmonary hemangioma

According to histogenesis, hemangioma is a dysontogenetic formation. The formation of pulmonary hemangioma is based on a congenital disorder of the development of vascular tissue (vasculogenesis), accompanied by its hyperplasia and the appearance of excess vascular buds. Vascular tumor cells begin their growth at the embryonic stage or shortly after the birth of the child. As part of a pulmonary hemangioma, atypically located elements of the vascular wall are detected, primarily, cells of the internal lining of blood vessels - endothelial cells, which have the ability to reproduce.

The risk of developing pulmonary hemangioma in a newborn increases if the mother’s pregnancy was complicated by taking certain medications (hormones, etc.), viral or bacterial infections, or an unfavorable environmental environment. In adults possible factors the appearance of pulmonary hemangioma are hereditary predisposition, prolonged exposure to ultraviolet radiation, internal pathology, contributing to vascular disorders.

Classification of pulmonary hemangioma

Hemangioma is a round tumor, surrounded by a connective tissue capsule, of dense or densely elastic consistency, which can have various shades of pink or red. The size of a hemangioma can vary from a few millimeters to 20 or more centimeters in diameter.

According to morphological criteria, hemangiomas can be capillary (simple or hypertrophic), cavernous (cavernous), combined and mixed. Capillary hemangiomas (about 50% of all types of this tumor) are represented by the proliferation and interweaving of dilated capillaries, usually with proliferation and hyperplasia of the endothelium, located in the form of concentric groups and elongated strands. More common in infants. Capillary hemangiomas are characterized by infiltrating growth, intensive new formation of small thin-walled vessels that even grow into the walls of arteries and veins.

Cavernous hemangiomas consist of multiple blood-filled arteriovenous cavities (sinusoidal areas) with thin connective tissue septa and endothelial lining. They are formed from larger blood vessels and can be significant in size. Combined (capillary-cavernous) hemangiomas combine proliferating areas of immature capillary elements and cavernous sinuses, limited by mature endothelial cells. Mixed hemangiomas are formed various types tissues (for example, angiokeratoma).

According to the localization of pulmonary hemangiomas, they are predominantly intrapulmonary, less often endobronchial; can be central or peripheral. Multiple hemangiomas affecting one or both lungs are common. There is a special sclerosing pulmonary hemangioma (pneumocystoma, fibroxanthoma, vascular endothelioma, alveolar angioblastoma) - a benign neuroendocrine pulmonary tumor, which contains hemangiomatous foci (angiomatous component). Pulmonary hemangioma is usually limited to the lung tissue and does not spread further; There are isolated cases of its invasion into the chest.

Symptoms of pulmonary hemangioma

The clinical picture of pulmonary hemangioma depends on the diameter, location and nature of the vascular formation. Due to slow growth over many years, the manifestations of a small hemangioma may be absent or quite sparse. Symptoms of pulmonary hemangioma usually develop when complications occur. With rapid growth, ulceration of the tumor is possible. Patients may be bothered by chest pain, hemoptysis, spontaneously occurring pulmonary hemorrhages (especially with cavernous hemangiomas).

With pulmonary hemangioma forming vascular (arteriovenous) fistulas between pulmonary artery and vein, hemodynamic disorders occur. Chronic hypoxemia leads to shortness of breath, cyanosis and frequent dizziness, children may also experience delays in growth and development. With vascular fistulas located at the level of segmental branches, the course of pulmonary hemangioma is asymptomatic. There is a gradual increase in polycythemia. Sometimes it is possible to detect noise in the vessels of the lung at the site of the tumor.

The danger of pulmonary hemangioma is possible rupture tumors (with trauma or severe ulceration) with massive blood loss and risk of death. It is possible to develop compression syndrome of blood vessels and tissues, infection of the ulcerated hemangioma with the occurrence of a purulent process in the lungs and deterioration of the patient’s condition.

Diagnosis of pulmonary hemangioma

The diagnosis of pulmonary hemangioma is established by a pulmonologist and is based on anamnesis and clinical picture (presence of episodes of hemoptysis or pulmonary hemorrhage), radiography, CT scan of the chest, ultrasound with Doppler, angiography of pulmonary vessels, bronchoscopy. Typically, pulmonary hemangiomas are discovered accidentally or already at the stage of complications. Indirect sign The tumor may be caused by the presence of telangiectasias in other organs and on the skin.

On a chest x-ray, hemangioma is visualized as a spherical or oval shape, having clear but usually irregular scalloped edges. An increased density of the lung root is often determined due to an increase in the pulmonary vessels. It is possible to detect a direct connection of the hemangioma with the pulmonary vessels, establish the autonomous pulsation of the tumor, a decrease in its shadow during exhalation, an increase in size and darkening during inspiration.

Ultrasound with Doppler sonography is highly informative for vascular tumors, as it allows you to determine the volume of hemangioma, its structure and hemodynamic state. Angiography confirms the vascular nature of the tumor formation, its localization and extent, and the characteristics of the hemangioma (clear limitation, presence of areas with a lobular structure, peripheral or axial nature of the blood supply). With endobronchial growth of a vascular formation, bronchoscopy is advisable.

The morphological, endoscopic and clinical-radiological picture of pulmonary hemangioma corresponds to the signs of a benign tumor. Differential diagnosis of pulmonary hemangioma is carried out with congenital angiodysplasias, other benign and malignant tumors of this localization.

Treatment of pulmonary hemangioma

Treatment of pulmonary hemangioma is only surgical, depending on the affected area, it comes down to excision of the tumor within healthy tissue, fenestrated or circular resection of the bronchus, segmental or marginal resection of the lung, removal of the pulmonary lobe (lobectomy), and rarely - removal whole lung(pneumonectomy). Surgical interventions performed by thoracic surgeons.

In the case of multiple pulmonary hemangiomas in both lungs, economical resection of the most affected areas is performed. It is advisable to remove the hemangioma in a more early dates, while the size of the formation is small, and there are no secondary irreversible changes in the lungs. When pulmonary hemorrhage develops with significant blood loss, blood transfusions, plasma and blood substitute transfusions are performed.

Watchful waiting can be used if peripheral location pulmonary hemangiomas and the absence of complications in elderly and senile patients. The prognosis of pulmonary hemangioma with timely surgical treatment is favorable.

Hemangioma

Hemangioma is the most common vascular tumor in childhood. It appears as red spots on various parts of the body, including the face. According to statistics, one child in a hundred is born with a hemangioma, and it attracts attention only with its color, increasing moderately in proportion to the child’s height, without causing him any unpleasant sensations.

However, its activity is very dangerous and destructive, since, having formed on the surface of the skin, it actively grows inside. And if a hemangioma in a child forms near one of the organs, then it can disrupt its functioning. So, if its location is near the ear, the hemangioma can destroy eardrum, and the child will lose hearing. For this reason, it must be neutralized as early as possible.

So, hemangiomas are simple (located on the surface of the skin), cavernous (located under the skin), combined (consisting of the skin and subcutaneous parts) and mixed (consisting of the hemangioma itself and other tissues - muscle or nervous), of which simple hemangiomas are found in 70–80% of cases.

The definitive cause of the appearance of hemangiomas is currently unclear, but there are several assumptions:

Bad ecology.

ARI that the mother suffered from in the first 3–6 weeks of pregnancy, when the formation of the fetal vascular system is underway.

Consequences of the mother taking various medications and drugs during pregnancy.

Hormonal characteristics of the child, especially those children who were born prematurely.

In 97% of cases, hemangiomas are detected at birth. But sometimes they appear in children in the first month of life and grow until six months of age, after which their growth usually slows down.

Simple hemangioma has a red or blue-purple color and is located superficially. This hemangioma is clearly demarcated, has a smooth surface and sometimes is somewhat protruding. A simple hemangioma affects the skin and a few millimeters of the subcutaneous fat layer. When pressed, it turns pale, but then regains its color. It grows mainly to the sides.

Cavernous hemangioma located under the skin in the form of a limited node. It looks like a tumor-like formation, covered with unchanged or bluish skin at the top. When pressed, the hemangioma collapses and turns pale, which occurs due to the outflow of blood.

Combined hemangioma are a combination of superficial and subcutaneous hemangioma (simple and cavernous).

Mixed hemangioma consists of tumor cells originating from blood vessels and other tissues. Appearance, color and consistency are determined by the tissues that make up the vascular tumor.

IN Lately Cases have become more frequent when children are diagnosed with multiple hemangeomatosis. There is a known case when one baby had to remove more than a hundred tumors. However, this is the exception rather than the rule.

Treatment. In the treatment of hemangioma, cryotherapy, administration of sclerosing drugs and electrocoagulation are used. However, the most effective and gentle method is laser photothermolysis, i.e. laser radiation, which is selectively absorbed by hemangioma tissue and blood, causing their damage without damaging surrounding tissue. Surgical treatment consists of excision of deeply located hemangiomas in closed areas of the body and limbs. However, their removal is associated with the risk of massive bleeding, therefore, for preventive purposes, preliminary ligation of the arteries feeding the tumor, suturing and suturing of hemangiomas are justified.

Treatment of hemangiomas located on the face, in the parotid region or on the neck is complicated due to the abundant blood supply to these parts of the body. But, fortunately, such tumors occur only in 0.5 % cases.

It is also very difficult to treat hemangiomas that are located in the area mammary gland in girls, on the hands and feet and in the perineum. Hemangiomas are especially dangerous for premature babies: they grow 2-3 times faster than in babies born at term.

However, about 7% of hemangiomas can disappear on their own as the child grows, which distinguishes them from other tumors. But, as a rule, the most harmless ones disappear - simple ones and located in closed areas of the body.

70% of hemangiomas are treated with the cryogenic method, using liquid nitrogen at a temperature of 196 °C. Healing occurs without a scar, which is very important for children. The number of cryotherapy sessions depends on the size of the hemangioma. A tumor up to 10 cm 2 in size can be removed at a time. Treatment is carried out on an outpatient basis, without anesthesia. As a rule, there are no complications. After completion of the procedures, no special therapy is required. It is enough for parents to treat the area where the hemangioma was with brilliant green and then with baby cream.

For deep cavernous hemangiomas (including on the face), the method of microwave cryodestruction is used. In this case, the hemangioma is irradiated with a microwave field and then subjected to cryotherapy.

Children in the first six months of life (with hemangiomas with a total area of more than 100 cm2 or occupying half of the child’s body) benefit greatly from hormone therapy using prednisolone tablets. For hemangiomas of the eye orbit and periorbital region, it is recommended radiation treatment. For tumors in the parotid region, on the face, and neck, a technique of angiography and embolization (that is, narrowing of blood vessels and blocking the blood flow to the tumor) has been developed.

The effectiveness of treatment of simple hemangiomas is 99.9%, complex - 98.6%. The goal of treatment is to eliminate the tumor process and obtain the best functional and cosmetic result. And the correctly chosen method, as well as timely treatment, can make your child not only healthy, but also beautiful.

Hemangioma is a common benign vascular formation.

Despite the possibility of self-healing and stopping the growth of hemangioma with subsequent disappearance, its further course still remains unpredictable.

Classification

Simple hemangioma - located on the surface of the skin;
Cavernous hemangioma - located under the skin;
Combined hemangioma - has subcutaneous and cutaneous parts;
Mixed hemangioma - consists of various tissues.

Symptoms of hemangioma

Simple hemangiomas have a red or blue-purple color, are located superficially, clearly demarcated, affect the skin and several millimeters of the subcutaneous fat layer, and grow mainly to the sides. The surface of hemangiomas is smooth, less often uneven, sometimes protruding somewhat above the skin. When pressed, hemangiomas turn pale, but then regain their color.

Cavernous hemangiomas are located under the skin in the form of a limited nodular formation, soft-elastic consistency and consist of different sizes cavities filled with blood. Cavernous hemangiomas look like a tumor-like formation covered with unchanged or bluish skin; with the growth of a vascular tumor, the skin acquires a blue-purple color. When pressed, the hemangioma collapses and turns pale (due to the outflow of blood); when the child cries, screams and coughs, it enlarges and becomes tense (due to the influx of blood).

Combined hemangiomas are a combination of superficial and subcutaneous forms (simple and cavernous). They appear depending on the combination and predominance of one or another part of the vascular tumor.

Mixed hemangiomas consist of tumor cells originating from blood vessels and other tissues (connective, nervous, etc.). The appearance, color and consistency are determined by the tissues that make up the vascular tumor.

Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute

Hemangiomas occur 2-3 times more often in girls than in boys.

They are usually detected immediately after birth and much less frequently during the first two months of life.

The favorite location of hemangiomas is the head and neck area. The rarest localization in the head and neck area is the parotid region.

Hemangiomas can be single or multiple.

A feature of hemangiomas in the perineal area and external genitalia is their tendency to frequent ulceration, which leads to self-healing of the tumor.

Diagnostics

Diagnosis of hemangioma is carried out by a surgeon using the following methods:

Inspection
Laboratory diagnostics
Ultrasound examination (determining the depth of tumor spread and calculating the volume of the formation; the location features, structure of the tumor are determined, measuring the speed of blood flow in the vessels).
Angiography (mandatory when examining patients with extensive and deep hemangiomas)

Treatment of hemangioma

Treatment of hemangiomas in most cases must begin as early as possible, immediately after diagnosis. Treatment is most effective in the first weeks and months of a child’s life.

Surgical treatment is indicated for deeply located vascular hemangiomas, when it is possible to remove the entire formation, within healthy tissue, without significant cosmetic damage. Operative method It is advisable to use treatment in cases where the use of other methods of therapy seems obviously ineffective. Treatment success is achieved in 90% of cases. Postoperative complications rare.

Hemangiomas of complex locations are subject to radiation treatment, primarily in areas where other treatment methods cannot be used, for example, the orbital area. Radiation therapy is also indicated for simple hemangiomas of a large area. Irradiation is carried out in separate fractions at intervals from 2-4 weeks to 2-6 months, until the hemangioma disappears. This treatment method is relatively complex and the effect takes quite a long time.

Only small, pinpoint hemangiomas are subject to diathermoelectrocoagulation (cauterization) in cases where the tumor is located in areas inaccessible to other treatment methods. Electrocoagulation of large and deep formations should not be used. Some patients experience cosmetic defects after electrocoagulation.

Sclerosing treatment is indicated for small, deep-seated vascular hemangiomas of complex location, especially in the treatment of small cavernous and combined forms on the face and tip of the nose. For injections use 70% alcohol. For combined hemangiomas, cryogenic or microwave cryogenic treatment is first performed to kill the superficial part of the tumor, and then sclerotherapy. The disadvantages of sclerotherapy are pain and duration of treatment. The advantage of injection therapy over others conservative methods treatment lies in its simplicity.

One of the methods for treating extensive external hemangiomas in children is hormonal treatment. It is carried out with the hormone prednisolone. Daily dose Prednisolone tablets are divided into 2 doses: at 6 o'clock in the morning the child receives 2/3 of the dose, at 9 o'clock in the morning - 1/3 of the dose. The drug is taken every other day without reducing the dosage. The duration of treatment is 28 days. If necessary, the course of treatment is repeated after 6-8 weeks. This method stops the growth of a vascular tumor. Follow-up treatment of hemangiomas after hormone therapy with other methods allows solving cosmetic problems.

The widespread use of low-temperature exposure is associated with the use special devices and freezing systems, which allows you to expand the capabilities of the method. Thanks to such important properties as painless, no bleeding and noticeable general reaction body - the cryogenic method is widely used in the treatment of hemangiomas. All simple hemangiomas of a small area, any location and at any age of the child are subject to cryogenic treatment. For therapeutic effects A hardware cryogenic method is used, where liquid nitrogen is used as a cooling agent. The optimal duration of cryotherapy is 20-25 seconds for hemangiomas located on the skin, and 7-10 seconds for hemangiomas located on the mucous membranes. The total area of cryotherapy should not exceed 10 cm2.

For simple hemangiomas, it is most advisable to use the cryogenic method.

In the treatment of simple hemangiomas of a large area, hormonal and radiation therapy are the methods of choice.

For cavernous and combined forms, sclerosing, surgical and microwave cryogenic methods are most effective.

For extensive and deep hemangiomas of the parotid region, it is effective complex treatment, which includes mandatory angiography and embolization of hemangioma.

Course and prognosis

The course of hemangiomas is benign in most cases. Modern techniques treatments allow you to choose best option therapy for a specific patient. Cosmetic defects after treatment are usually absent or insignificant.

Hemangiomas, which are more commonly known as red moles, are benign neoplasms originating from blood vessels.

Such red moles usually appear in children of both sexes; they are somewhat less common among adults. It is impossible to predict or prevent their occurrence.

At the moment, there is controversy regarding which pathology to classify hemangiomas as - congenital malformations or vascular tumors. Recent data confirm the development of tumors due to proliferation of the vascular endothelium and allow such neoplasms to be classified as vascular tumors.

What is a red mole?

Why are these moles red? The fact is that they are actually vascular tissue that is filled with blood. If ordinary moles are skin formations, then red moles are several small overgrown blood vessels. In a pronounced process, such accumulations merge into a single burgundy or blue spot.

Localization and prevalence

In most cases, such vascular tumors are diagnosed immediately after the birth of a child (87%), while in 70% of cases the patients are girls, who thus form the group increased risk. This pathology accounts for 48% of total number all tumors of the skin and soft tissues in childhood.

On a child’s body, red moles can be localized in absolutely any part, with about 80% of tumors located in the upper part of the body. Quite rarely, such formations are present on internal organs - bones, lungs, brain, liver.

Approximately 95% of all diagnosed tumors are simple formations.

Approximately 3% are cavernous.

About 2% are combined and mixed variants of the pathology.

Causes of occurrence

The reason for the appearance of such formations is still not known exactly. It is also difficult to explain why there are a large number of moles of this nature in the facial area. This is probably due to the abundant vascular network, which supplies facial tissues.

How does this happen? In the process of laying down systems and organs, vascular tissue permeates all parts of the body along a certain chain consisting of pericytic cells. Such cells act as unique conductors of information and react to the slightest lack of oxygen: if fetal tissues suffer from hypoxia, the synthesis of special proteins that attract pericyte cells is immediately launched. These cells begin to pave new pathways for blood supply to tissues, fighting hypoxia. In some cases, even after the lack of oxygen ceases, protein synthesis continues, and accordingly, the vascular tissue continues to develop and begins to form tumor-like formations.

The second name for vascular moles is vascular hyperplasia. Thus, we can say that the tumor is formed as a result of a disruption in the growth process of vascular tissues, which provokes an increase in its number. How and how this process occurs is quite difficult to answer with one hundred percent certainty, since for this it is necessary to carefully monitor all the features intrauterine development body tissues. The data presented are based on the results of autopsies of stillborn and aborted fetuses.

In adults

Acquired pathology is associated with the presence hormonal disorders and explains the appearance of hemangiomas in the adult population (diseases endocrine system, menopause, pregnancy, intake oral contraceptives or hormone therapy).

There are assumptions regarding the negative effects of radiation and ultraviolet irradiation, chemicals and viruses, which provoke the growth of tumors in adults.

Skin cracks and microtraumas with permanent damage capillary mesh can lead to the formation of such formations.

Uncompensated and long-term hypovitaminosis of vitamin C, which provokes thinning and fragility of capillaries, is also among the causes.

Red moles can accompany the course of other diseases (for example, cancer of internal organs, pathologies of the pancreas, liver). Often, the accumulation of red moles in a certain area of the body indicates a predisposition to cancer in this area or a nearby organ.

Red moles in newborns

This is a fairly common occurrence in newborns; it is also worth noting that if a newborn has a visual mole, it may disappear by 3-5 years. Since these are benign tumors, you should not be afraid if such formations:

do not bother the baby (pain, irritation, itching of the skin);

do not increase in size (doubling within a month, for example);

located in a non-hazardous place (if present on the nose, under the eye, on the genitals or face, its removal is indicated).

Red moles are characterized by rapid peripheral growth, which is especially intense in the first few months of a baby’s life. Therefore, about 10-12% of hemangiomas, according to medical indications, deleted. During the growth process, the tumor provokes tissue destruction and leads to a cosmetic and sometimes functional defect, especially in cases where the formation is located near vital organs (brain, ears, eyes). Disruption of the function of tissues and organs occurs as a result of their compression by the neoplasm.

Features in adults

In adults, primary hemangiomas do not arise; they are formed from existing, undiagnosed tumors. In most cases, even before school age therapy is carried out for visible formations, therefore, as an adult, either tumors on internal organs or untreated superficial formations can be detected.

Of particular danger are vascular tumors located on the spine, which are localized in the body of the spine, weakening its structure and can lead to fracture.

Classification

According to morphology

Cavernous - consists of large quantity cavities of various sizes and shapes, which are lined with a single layer of epithelial cells, which are similar in structure to the endothelium of blood vessels. In some cases, there is a rupture of the septa with the formation of papillary caverns in the lumen.

Capillary - the histological structure of the formation is compact layers or concentric groups of capillaries that are closely adjacent to each other. The wall of each vessel consists of several or one layer of epithelial-like cells and a basement membrane. The lumens of fused capillaries are filled shaped elements blood. In some cases, groups of vessels can form lobules that are separated by stroma.

According to their location, vascular hyperplasias are usually divided into:

cavernous - localized under the skin;

simple – located subcutaneously;

combined - there is a subcutaneous and supracutaneous part;

mixed, include other tumors, for example, lymphangioma, which originates from lymphoid tissue.

By origin:

congenital – occur in the first months after birth or immediately;

acquired – formed in adulthood. Acquired red moles can only have a simple location (supracutaneous). Complex shapes pathologies can be detected in the event of complications or by chance, and in this case they are congenital, which were not previously diagnosed.

With the flow:

Simple ones that do not pose a risk of organ dysfunction or complications.

close to vascular nodes or large vessels;

about or for life important organs and structures (ear, brain, eye);

in places that are difficult to access for intervention.

Features of hemangiomas

Vascular tumors differ in a number of ways characteristic properties, which distinguish them from other neoplasms:

rapid growth of the tumor during the first three months after the birth of the child;

accelerated (2-3 times, compared to full-term) growth of formations in premature infants;

the likelihood of spontaneous regression in the presence of simple tumors during the first five years of the baby’s life. This fact is explained by the stopping of the growth of hemangiomas in the event of exposure to a number of factors, namely cold, heat and certain chemicals;

the impossibility of spontaneous resolution of mixed, combined and cavernous variants of neoplasms;

unpredictability further development, even after stopping involution and growth.

Clinical picture

Simple angioma

A spot of varying size, usually red, that rises above the skin. With simultaneous finger pressure on the edge of such a tumor and healthy tissue, the angioma turns pale and shrinks; after the compression stops, it acquires its previous color and shape. In children under 3-4 months, the peripheral growth of vascular tumors is clearly visualized. This can be verified by making an initial stencil of the tumor from paper and applying it to the tumor after 15-30 days.

Cavernous angioma

Formation in the subcutaneous tissue with the presence of unchanged skin above it. May have diffuse character without clear boundaries or be encapsulated. There is a formation under the skin bluish tint, in some cases, feeding vessels may be visualized. When compression is created over the tumor, the formation decreases in size; after the pressure stops, the formation acquires its previous size.

The skin over the tumor may have a higher temperature than the surrounding tissue. No pulsation is observed above the formation. In some cases, when palpating the area, a lobular formation is felt. For cavernous hemangiomas, which are located on the head, near the ears and on the neck, fast growth with active diffuse germination into surrounding structures.

Combined angioma

Education with subcutaneous and skin part, the subcutaneous part is usually large.

Mixed tumors

Various options for combining a vascular neoplasm with keratoma, lymphangioma, lipoma and other types of neoplasms.

Spontaneous resolution

True regression of superficial or simple hemangiomas is observed in 10-15% of cases, especially in the case of tumors located in closed areas of the skin. The brightness of the formation decreases, whitish areas appear, and peripheral growth stops completely. After 6-8 months, the hemangioma turns into a whitish-pink smooth spot and does not rise above the skin. The skin under such a spot atrophies and by the age of 3-4 years leaves only a small area of depigmentation.

Complications

Red dots are dangerous rapid growth with subsequent compression of neighboring structures and disruption of their functions, which is especially important in the case of hemangiomas located in the brain, near the eye, or in the liver.

Infection (ulcerated, bleeding moles), attachment of bacterial infections to the skin.

Bleeding as a result of injury is especially dangerous in the case of extensive cavernous and combined neoplasms, as well as tumors that are located on internal organs, since such bleeding is quite difficult to stop.

Inflammation and ulceration as it grows. Some types of hemangiomas undergo reverse development after such complications.

Diagnostics

In the presence of superficial hemangioma, the diagnosis is determined on the basis of histological and clinical data. For deep and extensive processes, angiography is performed, which allows one to determine the presence of a connection between the vascular network and the tumor; radiography is also possible, which allows one to accurately determine the depth and size of the formation.

Treatment of red moles

Is it possible not to treat red moles? If the tumor does not threaten bleeding, does not impair organ function, or does not grow, such marks of intrauterine life can be left without treatment, especially considering the fact that such tumors do not carry the risk of malignancy. Moreover, you should not remove moles that are located on closed areas of the body (they do not cause cosmetic discomfort), do not bother you, and do not increase in size.

For extensive and deep-seated processes, the doctor will select treatment - conservative or surgical, to increase efficiency, these methods can be combined. Therapy directly depends on the type of tumor, its location and size, growth rate, age of the child and the presence of complications.

Simple hemangiomas

An effective method for treating small red moles is cryodestruction - low-temperature destruction. It can be performed in several ways: hardware cryodestruction using liquid nitrogen or direct application of crystalline carbon dioxide to the surface of the tumor for 15-20 seconds. The effectiveness of this therapy is 96%.

For simple formations large sizes Hormonal therapy with prednisolone at a rate of 4-6 mg per kilogram of body weight, taken at 6 o’clock in the morning with the third part of the dose and at 9 o’clock with the rest of the drug, helps best. The duration of therapy is 28 days with the drug taken every other day. Gradual withdrawal of the drug is not required; during treatment it is worth monitoring potassium and blood sugar levels.

Laser removal allows targeted action on the tumor, causing minimal damage to surrounding tissues. cosmetic defect. Modern laser systems that have various types pulse, are able to coagulate both superficial and deep-lying subcutaneous tumors without destruction of healthy tissue and the development of complications.

Cavernous

When the process is located in cosmetically unfavorable areas of the face (bridge of the nose, forehead, nose, cheeks), sclerosing therapy is used: a special substance is injected into the angioma, which causes aseptic necrosis followed by scarring of the tumor under the skin without scarring or tissue deformation. Hydrocortisone, sodium chloride solution 10%, quinine-urethane, 70% are used as sclerosing agents. ethanol. Complete sclerosis of the tumor requires 10-15 injections with breaks between manipulations of 14-30 days, so this process is quite lengthy.

When localizing cavernous hemangioma Surgical removal of the tumor is performed on the back, shoulder, hip and other closed areas of the body.

Combined

If the tumor is located in closed areas of the body, it is advisable to perform a radical surgical treatment. Removal of red moles can rarely lead to complications; the tumor is excised entirely with minimal cosmetic defect.

When the tumor is localized in open areas of the body or on the face, microwave cryodestruction is recommended: irradiation of the hemangioma using an ultra-high-frequency electromagnetic field, followed by cryodestruction. This combination of techniques makes it possible to significantly enhance the destructive effect of freezing, without impairing the ability of epithelial cells to recover.

Hormonal, sclerosing, and radiation therapy is also used using Beech rays, which have mid range between ultraviolet and x-ray irradiation.

Extensive and deep hemangiomas with a dangerous location

Such tumors are localized on the head, near the ears, on the neck and are characterized by constant growth (peripheral). The tendency for ulceration and bleeding of these types of angiomas does not allow the use of the methods described above.

In the presence of similar pathology Angiography must be performed, which will determine the nature of the hemangioma, its anatomical relationship with nearby structures and tissues. One of the most effective methods This type of therapy involves tumor embolization using a hydrogel, which reduces the size of the tumor by reducing its blood supply.

After this manipulation, cryodestruction is performed, which does not imply removal of the tumor itself: after the necrobiological process, the tumor partially resolves, leaving behind areas of atrophied skin; the resulting cosmetic defect can be eliminated using skin grafting if the patient so desires.