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Rapidly involuting congenital hemangioma (RICH) and noninvoluting congenital hemangioma (NICH)

Ilona J Frieden, MD
Denise Adams, MD
Section Editor
Moise L Levy, MD
Deputy Editor
Rosamaria Corona, MD, DSc


Congenital hemangiomas (CH) are rare, benign vascular tumors that, unlike infantile hemangiomas (IH), are present and fully grown at birth. They present as bossed plaques or exophytic masses located on the head, neck, or limbs (picture 1A-B). Based upon their natural history, two major subtypes of CH have been recognized: rapidly involuting congenital hemangiomas (RICH) and noninvoluting congenital hemangiomas (NICH) [1,2]. In most cases, RICH involute completely by the age of 14 months, whereas NICH never regress but grow in proportion with the child and may require eventual excision. A third intermediate subtype, the so-called partially involuting congenital hemangioma (PICH), shows overlapping features of RICH and NICH [3].

CH will be discussed in this topic. IH and other vascular tumors of childhood and capillary malformations are discussed separately.

(See "Infantile hemangiomas: Epidemiology, pathogenesis, clinical features, and complications".)

(See "Infantile hemangiomas: Evaluation and diagnosis" and "Infantile hemangiomas: Management".)

(See "Infantile hemangiomas: Management".)

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Literature review current through: Nov 2017. | This topic last updated: Apr 06, 2016.
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