Evaluation and diagnosis of infantile hemangiomas
- Denise W Metry, MD
Denise W Metry, MD
- Associate Professor of Dermatology and Pediatrics
- Baylor College of Medicine
Infantile hemangiomas are benign tumors of vascular endothelium. They are the most common tumors of childhood. Despite their benign and self-limited nature, some hemangiomas can cause complications such as ulceration or life-altering disfigurement. Occasionally, hemangiomas may compromise vital organ function or may occur in association with developmental anomalies.
The evaluation of infantile hemangiomas will be discussed here. The epidemiology, pathogenesis, clinical features, complications, and management are discussed separately. (See "Infantile hemangiomas: Epidemiology, pathogenesis, clinical features, and complications" and "Management of infantile hemangiomas".)
DIAGNOSIS AND EVALUATION
In the vast majority of cases the diagnosis of a hemangioma can be established clinically, based upon the history and physical examination . However, deeper subcutaneous lesions without the characteristic overlying skin changes and hepatic lesions (especially in the absence of a cutaneous hemangioma) may be very difficult to distinguish from vascular malformations or other tumors. Although imaging studies can be helpful [2-5], tissue biopsy is generally needed for definitive diagnosis in concerning cases.
History — Important aspects of the history for a child with a vascular lesion include :
●Age at which the lesion was first noted and subsequent behavior of the lesion.
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