Angioma and Hemangioma: What They Are, Types, and Whether It Is a Tumor

The word "angioma" usually comes up after a person or a child's parents notice a red spot or a raised nodule on the skin. "Hemangioma" sounds almost like an oncological diagnosis, although it refers to a vascular lesion. Let us sort out what is confirmed and where the everyday notion of "cancer of the vessels" ends.

Angioma and hemangioma: what they are

Red, pink, or bluish marks created by vessels near the skin surface are classified as vascular birthmarks. Hemangioma is a common variant: the color and shape are due to the proliferation of blood vessels in a specific location, and the cause is unknown. In pathological anatomy, hemangioma is defined as a benign tumor of endothelial cells of blood vessels that is capable of spontaneous involution. In reference books, cavernous hemangioma is also called an angioma.

Is it cancer or a benign vascular tumor

Hemangioma is not cancer. It is a benign vascular tumor: the word "tumor" here means tissue proliferation, not malignancy. The strongest objection is the natural course of infantile hemangiomas: strawberry marks disappear by age 7, and in most cases by age 9. Malignant vascular tumors do exist, and angiosarcoma is among the conditions a doctor rules out during differential diagnosis.

Types of hemangiomas

According to the ISSVA 2018 classification, hemangiomas are classified as vascular tumors and are divided into infantile, congenital, spindle cell, epithelioid, intramuscular, and others. Several have practical significance.

• Infantile — occurs in 2–10% of children, more often in girls, appears in the first month of life; grows until 5–6 months (sometimes until 9–12), then stabilizes and gradually decreases.
• Congenital — forms in utero and has its maximum size at birth, does not grow after birth; variants RICH, NICH, PICH.
• Cavernous — lies deeper and looks like red-bluish spongy tissue filled with blood.
• Strawberry (capillary) — raised red nodules made of closely spaced small vessels, more often on the neck and face.
• Hemangiomatosis — multiple (more than 4–5) small hemangiomas on the skin and mucous membranes.

Depth (superficial, deep, combined) and the area of involvement (focal, multifocal, segmental, indeterminate) are also taken into account separately. Lymphangioma is a separate lesion and is not discussed in this material.

Where they occur: skin, lip, eyelid, head, liver

The most common location of infantile hemangiomas is the head and neck. On the skin, the prognosis is usually favorable: after involution, a change in color or unevenness sometimes remains. The situation is different with the lip and eyelid: when located in the eye area, amblyopia and strabismus are possible, and proximity to the eye, nose, or mouth is a reason for examination. A rare complication is obstruction of the airways by a hemangioma in the laryngeal lumen. Liver hemangiomas in children may correspond to infantile, RICH, or PICH; in adults, they more often belong to other tumor processes.

When a lesion should be shown to a doctor

Reasons to show a lesion to a doctor: it is close to the eye, nose, or mouth; it has become larger, darker, or more nodular; it hurts; the appearance of the lesion is concerning. The diagnosis is made by appearance; for deep forms, skin biopsy, CT, and MRI are possible; for infantile hemangiomas, examination by a specialist and ultrasound are sufficient. Ulceration, infection, and bleeding are warning signs.

A vascular lesion by itself is not a reason to call an ambulance; 103 or 112 are needed if breathing difficulty occurs — for example, when a hemangioma in the laryngeal area obstructs the airways.

This material is for reference: it describes what is known about angiomas and hemangiomas and does not replace a doctor's consultation — the decision on observation or examination is made during an appointment.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer