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Hemangioma or Malformation?

If you are concerned that your child may have any of these medical conditions, please see your physician. My medical expertise lies only in my own research and is far from complete.


Vascular Malformations

Hemangiomas  are classified according to their location. They are deep, superficial or compound. They can also grow  internally: GI tract, liver, kidneys, adrenals, brain and  lungs.

Vascular  malformations are classified according to the type of  blood vessels involved.

Deep hemangiomas occur in lower dermis or subcutaneous  tissue below the collagen layer.

Midline  Venular (Capillary) malformations are flat macular  stains such as 'stork bites', 'salmon patches', and  'angel kisses'. The very small veins (venules) of this  lesion are always situated in the midline. These usually  fade within the first year of life.

Superficial hemangiomas occur in the upper dermis above the collagen  layer.

Venular  malformations are known as portwine stains, and  previously referred to as capillary malformations. The  venules of this lesion are located in the superficial  layer of the dermis.

Compound hemangiomas are a combination of both deep and  superficial lesions.

Venous  malformations are often erroneously referred to as  cavernous hemangiomas. They are comprised of large  dilated veins in the subcutaneous tissue.

Lymphatic  malformations were previously known as lymphangioma,  hemangiolymphangioma, and cystic hygroma. These lesions  form from dilated lymph vessels.

Mixed  malformations two or more types of vessels are  affected with this lesion: arteriovenous,  arteriovenous-capillary, venous-lymphatic,  venous-lymphatic capillary, and venular venous  malformations.


Vascular Malformations

Proliferation during the first year, hemangiomas alternate between  growing and resting. During growth most become raised,  shiny and bright red. Some, however, can be raised with  no red or superficial component. Cells within the lesion  multiply and form dense networks of tiny blood vessels.

Proliferation and Involution never occurs in vascular  malformations. Instead, slow steady growth is normal.

Involution is the process of shrinking that begins about 1 year  of age. The cells within the lesion lose their plumpness  and deflate. The lesion turns a dark maroon-like hue.

Growth of these lesions is by hypertrophy (enlargement of  vessels) rather than hyperplasia (increase in the number  of cells).

Half  of hemangiomas are slow regressors that may take  10-12 years to complete the involution cycle. Only 20  percent of slow regressors shrink completely.

In  some (high-grade lesions) the rate of growth is  more rapid. Other factors may stimulate periods of rapid  growth such as infection, trauma and hormonal changes.  Enlargement of the lesion is common at puberty and other  periods of hormonal modulation. Infection and trauma may  also result in sudden enlargement of a lymphatic  malformation.


Vascular Malformations

Incidence  of hemangiomas is 10-12 percent in  infants by 1 year of age (in 23 percent of low  birthweight babies). They are three to five times more  common in females. They are more common in whites. Blacks  and Asians have only a 0.2 percent incidence.

Incidence  of vascular malformations shows no  gender preference.

Venular  malformations occur in 0.3 percent of births

Lymphatic  malformations - Ninety percent are visible  within two years after birth.


  • 80 percent occur on  the head and neck.
  • 20 percent occur on  the trunk and extremities


  • 80 percent are  singular lesions
  • 20 percent are  multiple lesions

*** Infants with multiple  lesions (three or more) should be examined for  the possibility of internal lesions.***


  • Midline  venular (capillary) malformations usually occur in the head and neck area.
  • Venular  malformations occur on the head and neck  as the most common sites. Lips, tongue,buccal  mucosa, buccal fat space and from upper lip to  nasal vestibule are common.
  • Venous  malformations commonly occur on the head  or extremities.
  • Lymphatic  malformations commonly occur in the head  and neck area.
  • Mixed  malformations can occur anywhere on the  body.