For many years, all vascular anomalies were called hemangiomas. New insights over the past decade into the biology of infantile hemangiomas have led to a revised system of classification for these entities. The majority of hemangiomas appear on the head and neck, and otolaryngologists-head and neck surgeons are often the treating or consulting physicians. It is important for them and other specialists who see these lesions to be aware that there are important distinctions between garden variety hemangiomas (which account for the vast majority) and hemangiomas that can be more serious, even life-threatening.
Explore this issue:May 2006
Embryogenesis and Classification
The field is evolving and hemangiomas are a fertile area of research. Hemangiomas have a fascinating life cycle. They do not grow in utero, but blossom during the first few weeks of life. Most of them grow and resolve on their own. Hemangiomas hold a secret, and if we could understand why they grow and why they resolve, we might find a key for curing cancers, stated Francine Blei, MD, a pediatric hematologist/oncologist and Director of the Vascular Anomalies Program at New York University in New York City.
At present, there is no cohesive theory of the etiology of infantile hemangiomas, and the clinical heterogeneity suggests that there are multifactorial origins, Dr. Blei said. Some evidence suggests that the embryogenesis of hemangiomas involves cells of origin derived from the placenta that migrate into the fetal circulation during the first few weeks of life, when the fetus is mostly head and neck, explained Milton Waner, MD, Director of the Vascular and Birthmark Institute in New York City. Dr. Waner is an otolaryngologist-head and neck surgeon.