Abstract
Past descriptions of vascular lesions often confused vascular malformations and hemangiomas
using interchangeable definitions which led to inappropriate treatment and inconsistency
in the medical literature. The work of Mulliken and Glowacki systematically delineated
the difference between hemangiomas and the multiple varieties of vascular malformations.
Hemangiomas are in fact as the suffix “oma” suggests true tumors exhibiting cellular
proliferation on histology. Additionally, treatment has been clouded by numerous reports
in the literature of near universal complete spontaneous resolution and conversely
arguments that every lesion demands treatment. More recently, thoughtful studies of
the natural course of hemangiomas have been completed, algorithms for intervention
versus observation proposed, and effective safe treatment plans devised. The following
article will be presented in two sections. The first section will review the diagnosis
and natural history of hemangiomas as appreciated in modern literature and compare
this to a review of historical articles. This information will then be used to describe
a rational and thoughtful algorithm for observation or intervention and recommend
appropriate treatment options. Special emphasis will be given to surgical technique
and several cases of late involuting hemangiomas of the face will be presented.
KEYWORDS
Hemangioma - classification - management algorithim - vascular birthmark - cutaneous
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Edwin F WilliamsIII
M.D., F.A.C.S., Medical Director, Williams Center for Excellence
1072 Troy Schenectady Road, Latham, NY 12110