Internal hemangiomas: Description, identification, and management strategies
In the medical world, hemangiomas - non-cancerous tumours formed by the abnormal growth of excess blood vessels - can develop not only on the skin, but also in internal organs such as the liver and brain. This article aims to provide an overview of the various treatment options available for internal hemangiomas.
Hemangioblastomas, a type of internal hemangioma, are more common in women than men and tend to occur in people over 40 years of age. Conversely, hemangiopericytomas, though rarer, are more common in younger individuals.
Treatment for internal hemangiomas depends on their location, size, and the patient's overall health status. Here are some possible treatment options:
## Surgical Options
For hepatic (liver) hemangiomas, enucleation - the surgical removal of the hemangioma while preserving the surrounding tissue - is often used. In cases where the hemangioma is large or significantly impacts organ function, partial or total resection of the affected organ might be necessary.
In the case of brain hemangiomas, surgeons may remove problematic growths, and if complete removal is not possible, they may use focused radiation.
## Minimally Invasive Procedures
Arterial embolization, a technique that blocks the blood supply to the hemangioma, can reduce its size and alleviate symptoms, particularly for hepatic hemangiomas. Sclerotherapy, while more commonly used for superficial lesions, can be adapted for internal lesions in certain cases.
## Pharmacological Treatments
Corticosteroids can be used to reduce inflammation and size of the hemangioma, either intralesionally or orally. Interferon Alfa 2b, an antiviral drug, can inhibit the growth of hemangiomas by reducing angiogenesis.
A remarkable case involved the use of propranolol, a beta-blocker, to treat a child with an internal hemangioma.
## Laser Therapy
Laser therapy is effective for treating residual Infantile Hemangiomas and can be applied to other types of vascular lesions if they are accessible.
## mTOR Inhibitors
Sirolimus, an mTOR receptor inhibitor, has shown effectiveness in treating complex vascular malformations, including certain types of hemangiomas.
## Monitoring
For asymptomatic, non-aggressive lesions, monitoring may be sufficient to ensure they do not become symptomatic or grow significantly.
Research into anti-angiogenics, a class of medications that can help prevent the formation of new blood vessels, is ongoing. These drugs may prove helpful in treating internal hemangiomas.
It's essential to note that each treatment option should be tailored to the specific characteristics of the hemangioma. For instance, liver hemangiomas that are 4 cm or about 1.6 inches across can cause noticeable signs such as discomfort or a feeling of fullness in the stomach, while internal hemangiomas in the liver are usually small and do not produce any symptoms.
In rare instances, liver hemangiomas might cause symptoms like weight loss and nausea. Large liver hemangiomas in infants can lead to heart issues due to their effect on blood vessels. Pain may occur if the liver tumour bleeds or leads to a blood clot.
All brain tumours are uncommon, and brain hemangiomas make up a small proportion of these. Vascular tumours, or growths that develop from blood vessels, are rare in the brain.
In summary, while hemangiomas can pose a challenge due to their potential to grow and cause symptoms, a variety of treatment options are available. The key is to choose the most suitable treatment based on the specific characteristics of the hemangioma and the patient's overall health status. Always consult with a healthcare professional for accurate diagnosis and treatment recommendations.
- Hemangioblastomas, a type of internal hemangioma, are more common in women and tend to occur in people over 40 years of age, while hemangiopericytomas, though rarer, are more common in younger individuals.
- For liver hemangiomas, surgical options like enucleation or partial/total resection might be necessary if the hemangioma is large or impacts organ function.
- In the case of brain hemangiomas, surgeons may remove problematic growths, or use focused radiation if complete removal is not possible.
- Arterial embolization can reduce the size of hepatic hemangiomas and alleviate symptoms, while sclerotherapy can be adapted for internal lesions in certain cases.
- Pharmacological treatments such as corticosteroids, interferon Alfa 2b, or propranolol (used in a remarkable case of a child with an internal hemangioma) can help reduce inflammation, size, or growth of the hemangioma.
- Monitoring may be sufficient for asymptomatic, non-aggressive lesions, and research into anti-angiogenics, a class of medications that can help prevent the formation of new blood vessels, is ongoing, potentially proving helpful in treating internal hemangiomas.
