• Maria Armanda Passas Pediatric Department, Hospital Pediátrico Integrado, Centro Hospitalar São João
  • Marta Teixeira Dermatology and Veneorology Department, Hospital Pedro Hispano, Unidade de Saúde Local de Matosinhos.



Hemangioma, Vascular Malformations, Treatment


Infantile hemangiomas are the most common softtissue tumors of infancy, occurring in approximately 3 to 10 percent of one-year-old children, with predominance in females. Despite the frequency of these tumors, their pathogenesis is not completely understood, and the best approach to their management remains controversial. They have a well-described natural history of rapid growth during early infancy followed by gradual involution, often leading to complete regression. Because of their spontaneous involution, most infantile hemangiomas do not require therapeutic intervention. However, in 10 to 15 % of cases, treatment is necessary because of local complications, life or physiological functioning is threatened or the long-term esthetic risk is too high.


Download data is not yet available.


Mulliken JB, Glowacki J. Hemangiomas and vascular

malformations in infants and children: a classification based

on endothelial characteristics. Plast Reconstr Surg. 1982;


ISSVA Classification of vascular anomalies international

society for the study of vascular anomalies.

Vascular tumors and malformations. Habif. Clinical

Dermatology. 5th ed : Mosby, Elsevier, 2009, 23.

Morelli G.M. Vascular Disorders. Kliegman. Nelson Textbook

of Pediatrics. 19th ed. : Saunders, 2011.

Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am

Acad Dermatol. 2003; 48:477-93.

Finn MC, Glowacki J, Mulliken JB. Congenital vascular

lesions: clinical application of a new classification. J Pediatr

Surg 1983; 18: 894-9.

Hand JL, Frieden IJ. Vascular birthmarks of infancy: resolving

nosologic confusion. Am J Med Genet 2002; 108: 257-64.

C. Léauté-Labrèze, S. Prey, K. Ezzedine. Infantile

haemangioma: Part I. Pathophysiology, epidemiology, clinical

features, life cycle and associated structural abnormalities.

, JEADV, Vols. 25, 1245–53.

Goldsmith L A, Katz S I, Gilchrest B A, Paller A S, Leffell

D J Wolff K. Vascular tumors. Fitzpatrick’s Dermatology in

General Medicine. 7th. ed : MC Graw Hill, 2008, Vol.1.

Chiller KG, Passaro D, Fieden IJ. Hemangiomas of infancy.

Clinical characteristics, morphologic subtypes and their

relationship to race, ethnicity and sex. Arch Dermatol 2002;

: 1567–76.

Haggstrom AN, Drolet BA, Baselga E et al. Prospective study

of infantile hemangiomas: clinical characteristics predicting

complications and treatment. Pediatrics 2006; 118: 882–7.

Drolet BA, Esterly NB, Frieden IJ. Hemangiomas in children.

N Engl J Med. 1999; 341:173-81.

Kilcline C, Frieden IJ. Infantile hemangiomas: how common

are they? A systematic review of the medical literature.

Pediatr Dermatol. 2008; 25: 168-73.

Hoornweg MJ, Smeulders MJ, van der Horst CM. Prevalence

and characteristics of haemangiomas in young children. Ned

Tijdschr Geneeskd 2005; 149: 2455–8.

Fishman SJ, Mulliken JB. Vascular anomalies: a primer for

pediatricians. Pediatr Clin North Am 1998; 45: 1455-77.

Garzon MC, Drolet BA, Baselga E, Chamlin SL, Haggstrom AN,

Horii K, et al. Hemangioma Investigator Group. Comparison

of infantile hemangiomas in preterm and term infants: a

prospective study. Arch Dermatol. 2008 Sep;144(9):1231-2.

Burton BK, Schulz CJ, Angle B, Burd L. An increased incidence

of haemangiomas in infants born following chorionic villus

sampling (CVS). Prenat Diagn 1995; 15: 209-14.

Drolet BA, Swanson EA, Frieden IJ; Hemangioma Investigator

Group. Infantile hemangiomas: an emerging health issue

linked to an increased rate of low birth weight infants. J

Pediatr. 2008; 153: 712-5.

Drolet BA, Frieden IJ. Characteristics of infantile

hemangiomas as clues to pathogenesis: does hypoxia

connect the dots? Arch Dermatol 2010;146: 1295–9.

Lopez Gutierrez JC, Avila LF, Sosa G, Patron M. Placental

anomalies in children with infantile hemangiomas. Pediatr

Dermatol 2007; 24: 353–5.

Chang EI, Thangarajah H, Hamou C, Gurtner GC. Hypoxia,

hormones, and endothelial progenitor cells in hemangioma.

Lymphat Res Biol 2007; 5: 237–43.

Boye E, Yu Y, Paranya G et al. Clonality and altered behaviour

of endothelial cells from hemangiomas. J Clin Invest 2001;

: 745–52.

Yu Y, Fuhr J, Boye E et al. Mesenchymal stem cells and

adipogenesis in hemangioma involution. Stem Cells 2006;

: 1605–12.

Ritter MR, Butschek RA, Friedlander M, Friedlander SF.

Pathogenesis of infantile haemangioma: new molecular and

cellular insights. Expert Rev Mol Med 2007; 9: 1–19.

Jinnin M, Ishihara T, Boye E, Olsen BR. Recent progress in

studies of infantile hemangioma. J Dermatol 2010; 37: 283–98.

Khan ZA, Boscolo E, Picard A et al. Multipotential stem cells

recapitulate human infantile hemangioma in immunodeficient

mice. J Clin Invest 2008; 118: 2592–9.

Yu Y, Flint AF, Mulliken JB et al. Endothelial progenitor cells

in infantile hemangiomas. Blood 2004; 103: 1373–5.

Boye E, Jinnin M, Olsen BR. Infantile hemangioma:

challenges, new insights, and therapeutic promise. J

Craniofac Surg. 2009; 20: 678-84.

Razon MJ, Kraling BM, Mulliken JB, Bischoff J. Increased

apoptosis coincides with onset of involution in infantile

hemangioma. Microcirculation 1998; 5: 189–95.

Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies.

Curr Probl Surg 2000;37:519-84.

Esterly NB. Haemangiomas. In: Harper J, Oranje A, Prose N,

eds. Textbook of pediatric dermatology. Oxford: Blackwell

Science, 2000:997-1016.

Brandling-Bennett HA, Metry DW, Baselga E et al. Infantile

hemangiomas with unusually prolonged growth phase: a

case series. Arch Dermatol 2008; 144: 1632–7.

Chang LC, Haggstrom AN, Drolet BA, Baselga E, Chamlin

SL, Garzon MC, Horii KA, Lucky AW, Mancini AJ, Metry DW,

Nopper AJ, Frieden IJ; Hemangioma Investigator Group.

Growth characteristics of infantile hemangiomas: implications

for management. Pediatrics. 2008 Aug;122: 360-7.

Garzon MC, Frieden IJ. Hemangiomas: when to worry.

Pediatric Annals 2000; 29: 58-67.

Gampper TJ, Morgan RF. Vascular anomalies: hemangiomas.

Plast Reconstr Surg 2002; 110: 572-85.

Chamlin SL, Haggstrom AN, Drolet BA, Baselga E, Frieden IJ,

Garzon MC, Horii KA, Lucky AW, Metry DW, Newell B, Nopper

AJ, Mancini AJ. Multicenter prospective study of ulcerated

hemangiomas. J Pediatr. 2007 Dec;151: 684-9, 689-1.

Yap EY, Bartley GB, Hohberger GG. Periocular capillary

hemangioma: a review for pediatricians and family

physicians. Mayo Clin Proc 1998;73: 753-9.

Metry D, Heyer G, Hess C, Garzon M, Haggstrom A,

Frommelt P, et al. PHACE Syndrome Research Conference.

Consensus Statement on diagnostic criteria for PHACE

Syndrome. Pediatrics. 2009; 124: 1447-56.

Metry DW, Garzon MC, Drolet BA, Frommelt P, Haggstrom

A, Hall J, et al. PHACE syndrome: current knowledge, future

directions. Pediatr Dermatol. 2009;26: 381-98.

Metry DW, Haggstrom AN, Drolet BA, Baselga E, Chamlin S,

Garzon M, et al. A prospective study of PHACE syndrome

in infantile hemangiomas: demographic features, clinical

findings, and complications. Am J Med Genet A. 2006:1;140:


Orlow SJ, Isakoff MS, Blei F. Increased risk of symptomatic

hemangiomas of the airway in association with cutaneous

hemangiomas in a “beard” distribution. J Pediatr 1997;131:


Girard C, Bigorre M, Guillot B, Bessis D. PELVIS syndrome.

Arch Dermatol 2006; 142: 884–8.

Stockman A, Boralevi F, Taı¨eb A, Leaute´-Labre`ze C. SACRAL

syndrome: spinal dysraphism, anogenital, cutaneous, renal

and urologic anomalies, associated with an angioma of

lumbosacral localization. Dermatology 2007; 214: 40–5.

Horii KA, Drolet BA, Frieden IJ, Baselga E, Chamlin SL,

Haggstrom AN, et al. Hemangioma Investigator Group.

Prospective study of the frequency of hepatic hemangiomas

in infants with multiple cutaneous infantile hemangiomas.

Pediatr Dermatol. 2011;28: 245-53.

Frieden IJ, Haggstrom AN, Drolet BA, Mancini AJ,

Friedlander, SF, Boon L, et al. 2005. Infantile hemangiomas:

Current knowledge, future directions. In Proceedings of a

research workshop on infantile hemangiomas;7–9, 2005,

Bethesda, Maryland. Pediatr Dermatol 22: 383–406.

C. Léauté-Labrèze,S. Prey, K. Ezzedine Infantile

haemangioma: Part II. Risks, complications and treatment.

JEADV 2011, 25, 1254–60.

Kristen E. Holland, Beth A. Drolet, Infantile Hemangioma.

Pediatr Clin N Am. 2010; 57: 1069–83.

Hasan Q, Tan ST, Gush J et al. Steroid therapy of a

proliferating hemangioma: histochemical and molecular

changes. Pediatrics 2000;105: 117-20.

Bennet ML, Fleischer AB, Chamlin SL, Frieden IJ. Oral

corticosteroid use is effective for cutaneous hemangiomas. An

evidence based evaluation. Arch Dermatol 2001;137: 1208-13.

Shorr N, Seiff SR. Central retinal artery occlusion associated

with periocular corticosteroid injection for juvenile

hemangioma. Ophtalmic Surg 1986; 17: 229–31.

Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, Boralevi

F, Thambo JB, Taïeb A. Propanolol for severe hemangiomas

of infancy. N Engl J Med. 2008;358: 2649-51.

Price CJ, Lattouf C, Baum B, McLeod M, Schachner LA,

Duarte AM, Connelly EA. Propranolol vs corticosteroids for

infantile hemangiomas: a multicenter retrospective analysis.

Arch Dermatol. 2011;147(12):1371-6.

Léauté-Labrèze C, Taïeb A. Effecacité des bêtabloquants

dans les hémangiomes capillaires infantiles: signification

physiopathologique et conséquences thérapeutiques. Ann

Dermatol Venereol. 2008;135: 860-2.

Sans V, Dumas de la Roque E,Berge J, et al. Propranolol for

Severe Infantile Hemangiomas: Follow-Up Report. Pediatrics

; 124: 423.

Brain perfusion SPECT in Patients with PHACES Syndrome

under propranolol treatment Eur J Pediat Surg 2012; 22 :54-9.

Enjolras O, Breviere GM, Roger G, Tovi M,Pellegrino B,

Varotti E et al. Traitement par vincristine des hemangiomes

graves du nourrisson. Arch Pediatr 2004;11: 99-107.



How to Cite

Passas MA, Teixeira M. INFANTILE HAEMANGIOMA. REVNEC [Internet]. 2016Jun.21 [cited 2024May29];25(2):83-9. Available from:



Review Articles