Angioma

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 28, 2016
StartDiseasesAngioma

Angiomas are noncancerous tumors composed of lymphatic or vascular cell walls or the tissue around it. Angioma rarely becomes malignant tumors and typically appear near or on the surface of the skin. While angiomas are mainly benign tumors, they can indicate more serious issues such as cirrhosis, iodine deficiency, and bromine toxicity.

Contents

Definition & Facts

There are many types of angiomas or associated conditions. Hemangiomas are a type of angioma. An infantile hemangioma is a birthmark that grows on a child during the first year of birth, then often recedes almost completely by the age of 10. An infantile hemangioma typically appears on the face, back, scalp or chest. Cherry hemangioma can result from aging and appear in middle to old age. They usually appear on the torso.

Cavernous hemangioma can appear on the brain, liver, or eye. This is a group of dilated blood vessels that creates caverns that slow blood flow, hemorrhaging in surrounded tissue, and distended connection with nearby cells. Pyogenic granuloma or eruptive hemangioma are smooth or textured lesions that range in color from red to purple. These types of angioma are prone to bleed with or without trauma. 

Lymphangiomas are another type of angioma. Capillary lymphangiomas are hair-duct sized lymphatic vessels typically located in the epidermis. Cavernous lymphangioma are dilated lymphatic passageways that take over nearby tissues.

Glomangiomas are small, typically benign tumors typically found under the nail of a foot or fingertip. Naevus flammeus (also called port-wine stain) is an inflammation that often happens on the face and which remains throughout a person’s life, and telangiectasia (also known as spider veins) occurs in a spider-like fashion of swollen blood vessels beneath the skin surface and can indicate gastrointestinal bleeding or cirrhosis. Bacillary angiomatosis is blood vessel growth that forms masses that appear to be tumors throughout the body. 

Symptoms & Complaints

There are various symptoms for the specific types of angiomas. Cherry angiomas first appear to be a small, flat spot about a tenth of a millimeter. The diameter then grows and becomes thicker to become dome-like in appearance. Cherry angiomas may severely bleed when injured.

Infantile hemangioma typically occur in Caucasian premature babies on their neck and head. These hemangiomas resemble a bruise or red patch, while deeper hemangioma can begin to have a tumor-like appearance. Discomfort may occur if the lesion blocks an orifice or becomes bulky, but these types of hemangioma do not bleed unless cut.

Cavernous hemangioma can appear on the brain, liver, and eye. While this type of angioma is often asymptomatic, cerebral hemangioma can cause double vision, seizures, memory loss and stroke, liver hemangioma can cause abdominal pain and vomiting and eye hemangioma can cause vision difficulties.

Pyogenic granulomas can become painful and do not need to be touched to bleed severely. Pyogenic granulomas may also leak a oil-like substance, especially if located on the scalp. The diseases peripheral giant-cell granuloma and peripheral ossifying fibroma is also related to this condition. 

The capillary and cavernous forms of lymphangioma can create three distinctly types of signs and symptoms such as cosmetically unattractive reddish blisters, painless bulges that are present at birth and bulges underneath the skin of the groin, neck and armpit.

Glomus tumors are painful and may cause the nail bed to become elevated. Glomus tumors are sometimes associated with Kasabach-Merritt syndrome. Vascular ectasis can be related to red patches, Sturge-Weber syndrome, vomiting of black blood when the liver is affected, anemia, cardiac failure, headache, and chest pain.

Symptoms of reactive vascular proliferations vary according to what area is affected. At times this condition can cause inflamed papules or ulcerations, and it can also cause fever, pain and enlarged liver (hepatomegaly).

Causes

More research is needed to find the cause of many kinds of angiomas. It is thought that an estrogen imbalance plays a part in causing certain types of hemangiomas. Genetic disorders can cause of cystic lymphangioma. Telangiectasia can be a manifestation of cirrhosis, gastrointestinal bleeding, and esophagitis that result from scleroderma.

Genetic mutations can cause glomus tumors. Genetic mutations can cause naevus flammeus and telangiectasia. Bacillary angiomatosis can be caused by lice or a cat scratch or is associated with those who have a weakened immune system due to HIV/AIDS.

Diagnosis & Tests

Hemangiomas are mainly diagnosed with a physical examination and medical history; at times an ultrasound is used. Histopathologic inspection is used to diagnose lymphangioma as well as an ultrasound. A glomus tumor is determined by a physical exam as well as most forms of vascular ectasias.

Reactive vascular proliferations are determined by examination and growth history. Some types of angiomas such as certain types of telangiectasis require medical imaging (magnetic resonance imaging (MRI) and computed tomography (CT) scans) and genetic testing to distinguish abnormalities and rule out serious underlying disorders.

Treatment & Therapy

While most hemangiomas disappear on their own, treatments such as topical medical therapies, radiotherapy, laser therapy, and surgery may be used. Glomus tumors are surgically extracted. 

Nevus flammeus, a form of vascular ectasias, is treated with radiation, surgery, freezing and lasers. Cosmetics and tattooing are also used. Hereditary hemmorrhagic forms of angiomas have more involved treatments such as nasal packing, iron supplementation, and surgical procedures to treat nosebleeds, bleeding, and lesions affecting the lung, liver and brain. Bacillary angiomatosis is treated with antibiotics to prevent potentially life-threatening complications.

Prevention & Prophylaxis

Since the cause of many angiomas are often unknown, there are not many preventative methods available. Cherry angiomas, however, are associated with bromine poisoning; as such, avoidance of bromine may prevent its occurrence. Avoidance of breads, certain medicines, flame retardant materials and its presence in swimming pools can prevent cherry angiomas.

Genetic testing can help families planning for a child to determine if angiomas may develop in their child, and sun exposure protection can prevent angiomas such as spider telangiectasia from worsening. Bacillary angiomatosis can be caused by a cat bite or scratch, so the prevention of fleas in house cats can effectively prevent this type of infection.

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