What Is a Congenital Hemangioma?
A congenital hemangioma (hee-man-jee-OH-muh) is a type of birthmark that happens when a tangled group of blood vessels grow in or under a baby's skin. Congenital means present at birth, so babies who have these hemangiomas are born with them.
Congenital hemangiomas are less common and act differently from other kinds of hemangiomas seen in newborns.
What Are the Signs & Symptoms of a Congenital Hemangioma?
Most congenital hemangiomas are a circle or oval, but they can take any shape. They can be as large as 10 cm, and may range in color from pink to blue to very dark purple. They might look swollen and feel warm to the touch.
There are two types of congenital hemangiomas:
- rapidly involuting congenital hemangioma (RICH) — This type of hemangioma shrinks (involutes) without treatment and is mostly gone by the time a child is 12–24 months old.
- non-involuting congenital hemangioma (NICH) — This type of hemangioma does not shrink.
A congenital hemangioma that has both types mixed together is called a partially involuting congenital hemangioma (PICH).
A congenital hemangioma will grow as a baby grows, but not at a faster rate than the baby does. This means that the hemangioma will stay roughly the same size relative to the baby's body. This is called proportional growth. A RICH may have some proportional growth before it starts shrinking, but a NICH will continue proportional growth until the child is fully grown.
What Causes a Congenital Hemangioma?
The cause of congenital hemangiomas is unknown. Hemangiomas may run in families, but no genetic cause has been found.
Who Gets Congenital Hemangiomas?
Congenital hemangiomas are fairly rare. No risk factors have been found.
How Are Congenital Hemangiomas Diagnosed?
Congenital hemangiomas are often seen before birth on ultrasound images. An MRI may also provide helpful information about the hemangioma's size, blood flow, and connection to other body parts or blood vessels.
To see whether a congenital hemangioma is a RICH or NICH and to help decide how best to treat it, doctors may do a biopsy to examine cells under a microscope.
How Are Congenital Hemangiomas Treated?
A RICH usually won't need treatment because most shrink on their own. The skin usually looks better if a hemangioma shrinks naturally rather than being treated.
Treatment might be done for either kind of congenital hemangioma (RICH or NICH) if it:
- has broken down the skin (ulcerated)
- bleeds often
- interferes with breathing or vision
- makes the heart work too hard pumping blood
Multiple treatments might be used:
- ligation: tying off the blood supply to the hemangioma in a surgical procedure
- excision: removing the hemangioma with surgery
- embolization: using a long, thin tube (catheter) placed in the blood vessel to block the blood flow to the hemangioma
After a congenital hemangioma shrinks or is surgically removed, it's unlikely to come back. It may leave a flap of stretched skin that can be surgically removed.
A baby born with a congenital hemangioma does not have any higher risk for other health problems than other newborns.