Vascular Disorders and Anomalies

Abstract

Vascular tumors are distinguished from vascular malformations by the presence of mitosis, or increased endothelial turnover. Vascular tumors can be benign, locally aggressive, or malignant. Infantile hemangiomas, the most prevalent vascular tumor, are largely benign entities, but can be functionally and cosmetically impairing if not treated in a timely manner. This chapter addresses infantile hemangiomas, vascular tumors with serious consequences (Kasabach-Merritt phenomenon and multifocal lymphangioendotheliomatosis with thrombocytopenia), and common benign tumors (pyogenic granulomas and angiofibromas).

Vascular malformations are static lesions present at birth, and are classified based upon the type of blood vessels that are involved, and as simple (one vessel type) or combined (two or more vascular malformations in one lesion). They are typically noted at birth, grow in proportion with the patient, and consist of abnormal vessels; some are associated with other anomalies such as overgrowth or leptomeningeal malformations, which, based upon their location or exam, may prompt additional workup and treatment. For patients with complex or combined vascular malformations, a combination of the above techniques is often used, depending on malformation location, size, and morbidity.