Pediatrics

Cavernous Hemangioma - How Dangerous Is It?

Definition - What is Cavernous Hemangioma?

A hemangioma consists of malformed blood vessels. They are also commonly called blood sponges. These are benign growths that displace the surrounding tissue, but are usually harmless. They can be found on different tissues, such as the eye socket, the skin, or the liver.

The cavernous hemangioma is a special form of the hemangioma: the blood vessels that make up it form larger cavities. These cavities are also called caverns and thus give the hemangioma its name. In the cavernous hemangioma, venous-arterial connections can form, which can lead to bleeding due to the increased pressure.

In general, hemangiomas are observed and if they increase in size, they are obliterated with cold or laser or surgically removed. However, they very often regress on their own.

For general information about hemangioma, see: Hemangioma

Causes of Cavernous Hemangioma

Hemangiomas are often present before birth and no precise cause for their development can be determined. The basic mechanism lies in the incorrect arrangement of the blood vessels.

Cavernous hemangiomas only appear before birth or a few days after birth, they usually do not form again during life. It is therefore not possible to describe any causal mechanisms that favor the development of a cavernous hemangioma. If the hemangiomas do not regress, they can cause symptoms in the course of life that are either triggered by displacing growth or bleeding.

Locations of the cavernous hemangioma

Cavernous hemangioma in the liver

Cavernous hemangiomas occur in many tissues, in principle all tissues with blood vessels are possible.

A cavernous hemangioma in the liver may remain undetected or it may only become noticeable late in the form of bleeding. Hemangiomas in general are often an incidental finding during the ultrasound examination of the abdomen. Most hemangiomas do not require any therapy, it is different with persistent bleeding. Here methods are used with which the hemangioma is obliterated and thus can no longer bleed.

Do you have a hemangioma in your liver and want to know more about it? To do this, read: Hemangioma in the liver

Cavernous hemangioma in the brain

Cavernous hemangiomas also occur in the brain. Often the hemangiomas located in the brain are not discovered or only discovered by chance. In some cases, however, epileptic seizures can occur, which are caused by the displacing growth of the hemangioma. In contrast to other vascular malformations of the brain, the cavernous hemangioma often does not lead to critical bleeding.

For symptoms that can be traced back to the hemangioma in the brain, the only treatment option is neurosurgical intervention to remove the malformation.

How do you recognize a hemangioma-induced cerebral hemorrhage? This article might also interest you: What are the signs of a cerebral hemorrhage?

Cavernous hemangioma in the eye socket

Cavernous hemangiomas, which are located in the eye socket, also known as the orbit, lead through their growth to the displacement of other structures that are located there. The eye socket is a very narrow space in which the eyeball, eye muscles, several nerves and vessels are located. The growth of a cavernous hemangioma results in symptoms caused by the displacement.

There may be a visible protrusion of the eye. In this case it is typical that the affected eye protrudes further than the unaffected one.

The muscles used to move the eyeball may also be affected. In this case, the eye can only be moved insufficiently in a certain direction. This is noticeable through double images.

Another symptom is a red-looking eye with prominent blood vessels. The reason for this is a flow obstruction caused by the cavernous hemangioma.

You can also find important information about reddened eyes here: Reddened eyes in children and babies

Cavernous hemangioma in the skin

A cavernous hemangioma often forms on the skin. It can be very small to begin with and grow in size over time. The hemangioma is dark blue to purple in color and can appear threatening to inexperienced observer. It's painless and soft to the touch.

If the hemangioma does not resolve, it may affect the growth of young children, in which case it should be removed.

Can the hemangioma cause a skin tumor? For the causes of a skin tumor, read: Skin cancer in baby

I recognize a cavernous hemangioma by these symptoms

It is relatively rare for a cavernous hemangioma not to resolve by the age of five. However, it can happen that a very slowly growing hemangioma does not cause symptoms until old.

For hemangiomas of the skin, you may notice a soft bluish-purple colored bump that is not painful. The hemangioma may bleed profusely if injured.

A hemangioma of the liver is often symptom-free and is only discovered by chance. So you cannot find any symptoms in yourself that are indicative of a hemangioma of the liver.

If there is a hemangioma in the eye socket, you may notice a feeling of pressure behind the eye. You may also notice a slight protrusion of the eyeball.

A cavernous hemangioma of the brain may never cause symptoms in a lifetime. However, there is a possibility that an epileptic fit will occur. If this is the case for you, you will be examined very carefully by specialists. They will have brain imaging and other neurological tests done. The investigation of the causes of an epileptic seizure is very extensive and if a hemangioma has triggered the epilepsy, it will be found with a very high probability.

You might also be interested in these topics:

Epileptical attack
Pain behind the eye

Diagnosis of a cavernous hemangioma

The diagnosis of cavernous hemangioma is made clinically when it is on the skin. This means that a cavernous hemangioma, given its typical appearance, can be diagnosed with a physical exam.

However, if a hematoma forms on internal organs, the diagnosis is usually made through imaging. A hemangioma of the liver can be seen on ultrasound and can usually be distinguished from other growths.

A hemangioma in the head area, i.e. in the eye socket or in the brain, is diagnosed by a CT or MRI examination.

Treatment of Cavernous Hemangioma

Cavernous hemangioma very often heals on its own without the need for treatment. In any case, however, it should be observed and removed if it increases in size.

There are several methods available for treating the hemangioma. In the case of smaller and easily accessible hemangiomas, treatment is based on sclerotherapy of the blood vessels that make up the hemangioma. This sclerotherapy can be carried out with the help of freezing, this method is also called cryotherapy.

Another method of sclerotherapy is the laser. Lasers use focused light that generates heat. The vessels are in turn deserted by the heat.

In rarer cases, the hemangioma may need to be removed using surgical procedures.

Newer approaches include the treatment of cavernous hemangiomas using beta blockers, an established group of active substances in the treatment of cardiovascular diseases. In the treatment of cavernous hemangioma, good results were achieved with the beta blocker propanolol.

Course of the disease in cavernous hemangioma

The disease usually occurs during or a few days after childbirth. The cavernous hemangioma either disappears after months or years, it remains the same size and does not cause any problems, or it grows and needs treatment.

No new hemangiomas develop in the course of life, but they can only be detected in old age if they only increase in size very slowly. With adequate treatment, life expectancy is usually not restricted.

Prognosis of a cavernous hemangioma

In most cases the prognosis is very good. Very often a cavernous hemangioma resolves spontaneously and never causes problems again. Even in cases where the hemangioma increases in size, the prognosis is very positive with appropriate treatment.

For cavernous hemangiomas that occur in more critical locations, such as the brain or the airways, the prognosis may be slightly worse. In these cases, too, the treatment leads to a significant reduction in the risk of severe disease progression.

Only the risks involved in removing more complicated hemangiomas slightly worsen the prognosis.