Semin Plast Surg 2006; 20(3): 163-168
DOI: 10.1055/s-2006-949118
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Surgery: The Treatment of Choice for Hemangiomas

Vincent C. Boyd1 , Dana Bui2 , Bindi Naik1 , Moise L. Levy1 , 3 , 4 , 5 , M. John Hicks1 , 6 , Larry Hollier1  Jr. 
  • 1Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
  • 2The University of Texas Health Science Center at Houston Medical School, Houston, Texas
  • 3Dermatology Services and Birthmark Center, Texas Children's Hospital, Houston, Texas
  • 4Department of Dermatology, Texas Children's Hospital, Houston, Texas
  • 5Department of Pediatrics, Texas Children's Hospital, Houston, Texas
  • 6Surgical and Ultrastructural Pathology, Texas Children's Hospital, Houston, Texas
Further Information

Publication History

Publication Date:
18 September 2006 (online)

ABSTRACT

The management of hemangiomas has always been a matter of controversy. Traditionally, observation has been the mainstay of therapy, with the expectation that most of the lesions will disappear spontaneously. This treatment plan was based on the premise that surgical excision or other treatments might produce a worse result than simply waiting for the lesion to resolve with an acceptable cosmetic result. This plan has been challenged because of a growing number of specialty teams that address these lesions. This article examines various cases of pediatric hemangioma and evaluates the possibility of surgical excision as a first-choice treatment in these cases. One hundred fifteen cases of surgical excision of pediatric hemangiomas performed by a single surgeon over a period of 7 years were examined. Pre- and postoperative photographs were examined. Hemangioma location, size, and type; patient's age; and surgical technique are described. Acceptable cosmetic and functional results were achieved in all surgical cases. Early excision of hemangioma should be the procedure of choice in selected cases of hemangioma. Hemangiomas in areas where a significant cosmetic defect or functional defect might ensue should have surgical excision considered as first-line treatment.

REFERENCES

  • 1 Marler J J, Mulliken J B. Current management of hemangiomas and vascular malformations.  Clin Plast Surg. 2005;  32 99-116
  • 2 Braiker B. “Doctors Re-examine ‘Strawberry Marks’ in Babies,”, New York Times, December 20, 2005, sec F, p 6. 
  • 3 Buckmiller L M. Update on hemangiomas and vascular malformations.  Curr Opin Otolaryngol Head Neck Surg. 2004;  12 476-487
  • 4 Thomson H G, Lanigan M. The Cyrano nose: a clinical review of hemangiomas of the nasal tip.  Plast Reconstr Surg. 1979;  63 155-160
  • 5 Pitanguy I, Machado B H, Radwanski H N, Amorim N F. Surgical treatment of hemangiomas of the nose.  Ann Plast Surg. 1996;  36 586-592
  • 6 Van Doorne L, De Maeseneer M, Stricker C, Vanrensbergen R, Stricker M. Diagnosis and treatment of vascular lesions of the lip.  Br J Oral Maxillofac Surg. 2002;  40 497-503
  • 7 Van Aalst J A, Bhuller A, Sadove A M. Pediatric vascular lesions.  J Craniofac Surg. 2003;  14 566-583
  • 8 Weinstein J M, Chamlin S L. Quality of life in vascular anomalies.  Lymphat Res Biol. 2005;  3 256-259
  • 9 McHeik J N, Renauld V, Duport G, Vergnes P, Levard G. Surgical treatment of hemangioma in infants.  Br J Plast Surg. 2005;  58 1067-1072
  • 10 Boon L M, Enjolras O, Mulliken J B. Congenital hemangioma: evidence of accelerated involution.  J Pediatr. 1996;  128 329-335
  • 11 Kagawa K, Park S, Taniguchi K. Infantile fibrosarcoma. Report of two cases.  Scand J Plast Reconstr Surg Hand Surg. 1999;  33 105-109
  • 12 Boon L M, Fishman S J, Lund D P, Mulliken J B. Congenital fibrosarcoma masquerading as congenital hemangioma: report of two cases.  J Pediatr Surg. 1995;  30 1378-1381

Vincent C BoydM.D. 

Division of Plastic Surgery, Baylor College of Medicine

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