Cavernous hemangioma, vertebral body hemangioma, and synovial hemangioma = venous malformations
IH: Benign vascular neoplasm (not malformation) of proliferating endothelial cells
Most common soft tissue tumor of infancy
Not vascular malformation
2018 revised classification by International Society for Study of Vascular Anomalies (ISSVA) retains 2 main categories
Vascular tumors: True neoplasms with cellular proliferation; generally grow out of proportion to patient
Vascular malformation: Congenital errors of vessel development; generally grow commensurate with patient
IMAGING
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
Immunohistochemical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Gong X et al: Conventional ultrasonography and elastography for the diagnosis of congenital and infantile hemangiomas. J Dermatol. 47(5):527-33, 2020
Saito M et al: Usefulness of diffusion-weighted magnetic resonance imaging using apparent diffusion coefficient values for diagnosis of infantile hemangioma. J Comput Assist Tomogr. 43(4):563-7, 2019
Johnson CM et al: Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 1: classification, sonographic approach and vascular tumors. Pediatr Radiol. 47(9):1184-95, 2017
Laken PA: Infantile hemangiomas: pathogenesis and review of propranolol use. Adv Neonatal Care. 16(2):135-42, 2016
Merrow AC et al: 2014 Revised classification of vascular lesions from the International Society for the Study of Vascular Anomalies: radiologic-pathologic update. Radiographics. 36(5):1494-516, 2016
Wassef M et al: Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics. 136(1):e203-14, 2015
Blei F et al: Current workup and therapy of infantile hemangiomas. Clin Dermatol. 32(4):459-70, 2014
International Society for the Study of Vascular Anomalies: 2018 classification. Published May 2018. Accessed July 2021. http://issva.org/classification
Nasseri E et al: Partially involuting congenital hemangiomas: a report of 8 cases and review of the literature. J Am Acad Dermatol. 70(1):75-9, 2014
Bingham MM et al: Propranolol reduces infantile hemangioma volume and vessel density. Otolaryngol Head Neck Surg. 147(2):338-44, 2012
Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 1: overview and clinical and imaging characteristics. Pediatr Radiol. 41(7):895-904, 2011
Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 2: endangering hemangiomas and treatment. Pediatr Radiol. 41(7):905-15, 2011
Holmes WJ et al: Propranolol as first-line treatment for infantile hemangiomas. Plast Reconstr Surg. 125(1):420-1, 2010
Maturo S et al: Initial experience using propranolol as the sole treatment for infantile airway hemangiomas. Int J Pediatr Otorhinolaryngol. 74(3):323-5, 2010
Sinno H et al: Management of infantile parotid gland hemangiomas: a 40-year experience. Plast Reconstr Surg. 125(1):265-73, 2010
Storch CH et al: Propranolol for infantile haemangiomas - insights into the molecular mechanisms of action. Br J Dermatol. 163(2):269-74, 2010
Metry D et al: Consensus statement on diagnostic criteria for PHACE syndrome. Pediatrics. 124(5):1447-56, 2009
Judd CD et al: Intracranial infantile hemangiomas associated with PHACE syndrome. AJNR Am J Neuroradiol. 28(1):25-9, 2007
Drolet BA et al: Early stroke and cerebral vasculopathy in children with facial hemangiomas and PHACE association. Pediatrics. 117(3):959-64, 2006
Rossi A et al: Agenesis of bilateral internal carotid arteries in the PHACE syndrome. AJNR Am J Neuroradiol. 27(8):1602, 2006
Kronenberg A et al: Ocular and systemic manifestations of PHACES (posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects and coarctation of the aorta, eye abnormalities, and Sternal abnormalities or ventral developmental defects) syndrome. J AAPOS. 9(2):169-73, 2005
Robertson RL et al: Head and neck vascular anomalies of childhood. Neuroimaging Clin N Am. 9(1):115-32, 1999
Mulliken JB et al: Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 69(3):412-22, 1982
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Infantile hemangioma (IH)
Synonyms
Capillary hemangioma
Definitions
Widespread misuse of term "hemangioma" in literature
Infantile hemangioma (IH) is different entity from
Cavernous hemangioma, vertebral body hemangioma, and synovial hemangioma = venous malformations
IH: Benign vascular neoplasm (not malformation) of proliferating endothelial cells
Most common soft tissue tumor of infancy
Not vascular malformation
2018 revised classification by International Society for Study of Vascular Anomalies (ISSVA) retains 2 main categories
Vascular tumors: True neoplasms with cellular proliferation; generally grow out of proportion to patient
Vascular malformation: Congenital errors of vessel development; generally grow commensurate with patient
IMAGING
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
Immunohistochemical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Gong X et al: Conventional ultrasonography and elastography for the diagnosis of congenital and infantile hemangiomas. J Dermatol. 47(5):527-33, 2020
Saito M et al: Usefulness of diffusion-weighted magnetic resonance imaging using apparent diffusion coefficient values for diagnosis of infantile hemangioma. J Comput Assist Tomogr. 43(4):563-7, 2019
Johnson CM et al: Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 1: classification, sonographic approach and vascular tumors. Pediatr Radiol. 47(9):1184-95, 2017
Laken PA: Infantile hemangiomas: pathogenesis and review of propranolol use. Adv Neonatal Care. 16(2):135-42, 2016
Merrow AC et al: 2014 Revised classification of vascular lesions from the International Society for the Study of Vascular Anomalies: radiologic-pathologic update. Radiographics. 36(5):1494-516, 2016
Wassef M et al: Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics. 136(1):e203-14, 2015
Blei F et al: Current workup and therapy of infantile hemangiomas. Clin Dermatol. 32(4):459-70, 2014
International Society for the Study of Vascular Anomalies: 2018 classification. Published May 2018. Accessed July 2021. http://issva.org/classification
Nasseri E et al: Partially involuting congenital hemangiomas: a report of 8 cases and review of the literature. J Am Acad Dermatol. 70(1):75-9, 2014
Bingham MM et al: Propranolol reduces infantile hemangioma volume and vessel density. Otolaryngol Head Neck Surg. 147(2):338-44, 2012
Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 1: overview and clinical and imaging characteristics. Pediatr Radiol. 41(7):895-904, 2011
Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 2: endangering hemangiomas and treatment. Pediatr Radiol. 41(7):905-15, 2011
Holmes WJ et al: Propranolol as first-line treatment for infantile hemangiomas. Plast Reconstr Surg. 125(1):420-1, 2010
Maturo S et al: Initial experience using propranolol as the sole treatment for infantile airway hemangiomas. Int J Pediatr Otorhinolaryngol. 74(3):323-5, 2010
Sinno H et al: Management of infantile parotid gland hemangiomas: a 40-year experience. Plast Reconstr Surg. 125(1):265-73, 2010
Storch CH et al: Propranolol for infantile haemangiomas - insights into the molecular mechanisms of action. Br J Dermatol. 163(2):269-74, 2010
Metry D et al: Consensus statement on diagnostic criteria for PHACE syndrome. Pediatrics. 124(5):1447-56, 2009
Judd CD et al: Intracranial infantile hemangiomas associated with PHACE syndrome. AJNR Am J Neuroradiol. 28(1):25-9, 2007
Drolet BA et al: Early stroke and cerebral vasculopathy in children with facial hemangiomas and PHACE association. Pediatrics. 117(3):959-64, 2006
Rossi A et al: Agenesis of bilateral internal carotid arteries in the PHACE syndrome. AJNR Am J Neuroradiol. 27(8):1602, 2006
Kronenberg A et al: Ocular and systemic manifestations of PHACES (posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects and coarctation of the aorta, eye abnormalities, and Sternal abnormalities or ventral developmental defects) syndrome. J AAPOS. 9(2):169-73, 2005
Robertson RL et al: Head and neck vascular anomalies of childhood. Neuroimaging Clin N Am. 9(1):115-32, 1999
Mulliken JB et al: Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 69(3):412-22, 1982
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