Vascular and lymphatic neoplasms

Chapter 42 Vascular and lymphatic neoplasms



Joseph G. Morelli, MD




1. Which is the most common benign vascular neoplasm of childhood?
Hemangioma of infancy (HOI), which is a benign tumor of capillary endothelium. This tumor typically presents at ages 2 to 8 weeks and then goes through a rapid growth phase for the first 6 to 9 months of life. It then begins to regress, with complete regression in 50% of patients by age 5 years. Regression does not necessarily imply return of the skin to normal.

Kilcline C, Frieden IJ: Infantile hemangiomas: how common are they? A systematic review of the medical literature, Pediatr Dermatol 25:168–173, 2009.


2. What are the clinical subtypes of HOI?
• Superficial: Bright red papules

• Deep: Soft blue nodule (Fig. 42-1)

• Mixed: Combination of the above
image

Figure 42-1. Deep hemangioma.


Most HOI are clinically the mixed type.


3. Name the complications of hemangiomas.
Obstruction of a vital function (such as vision, breathing, eating, defecation, or urination), ulceration followed by bleeding and infection, and high-output cardiac failure. High-output cardiac failure rarely results from a solitary cutaneous HOI.

4. What is the most common complication of hemangiomas?
Ulceration is the most frequent complication and occurs predominantly in the diaper areas (Fig. 42-2).

5. Are there any residua of hemangiomas after regression?
Hypopigmentation, telangiectasia, excess skin, fibrofatty deposits, and, if ulceration occurred, scarring (Fig. 42-3).

6. What is Kasabach-Merritt syndrome?
Platelet trapping and consumption coagulopathy associated with a vascular tumor.
image

Figure 42-2. A, Ulcerated hemangioma. B, The same hemangioma three months after one pulsed dye laser treatment.


image

Figure 42-3. Scarring, hypopigmentation, and telangiectasia after regression of a hemangioma.


Rodriguez V, Lee A, Wiltman PM, Anderson PA: Kasabach-Merritt phenomenon: case series and retrospective review of the Mayo Clinic experience, J Pediatr Hematol Oncol 31:522–526, 2009.


7. Name the two vascular tumors most commonly associated with the Kasabach-Merritt syndrome.
Kaposiform hemangioendothelioma and tufted angioma.

8. Port wine stains and lymphangiomas are not neoplasms. What are they?
They are vascular malformations.

9. What is the difference between a vascular malformation and a vascular neoplasm?
A vascular malformation is a developmental error. A vascular neoplasm is a tumor. Vascular malformations stay rather static and grow proportionately with the patient. Vascular tumors grow at a rate greater than the patient does.

10. What is Klippel-Trénaunay syndrome?
This is overgrowth of an extremity secondary to a vascular malformation. The overgrowth invariably involves soft tissue but can also affect the bone (Fig. 42-4). The vascular malformation may be a capillary malformation (port wine stain), a venous malformation, or a combination of the two.

Only gold members can continue reading. Log In or Register to continue

Related posts:

Vasculitis Lasers in dermatology Cutaneous manifestations of AIDS Dermatoses of pregnancy Therapeutic photomedicine Special considerations in skin of color

Stay updated, free articles. Join our Telegram channel
Tags:
Apr 26, 2016 | Posted by in Dermatology | Comments Off on Vascular and lymphatic neoplasms

Full access? Get Clinical Tree
Get Clinical Tree app for offline access