Cavernous hemangioma is a benign neoplasm of blood or lymph vessels. However, the lack of typical features of malignancy does not exclude he alth problems that may result from its unfavorable location. What exactly are cavernous hemangiomas and what are the symptoms? How is the treatment going?
Cavernous hemangioma(from Latin haemangioma cavernosum) is a form of dilated vascular spaces filled with blood. It is a relatively well-limited change. The blood flow within it is slow, which promotes its clotting. Unlike capillary hemangioma - the most common type of hemangioma, it does not regress spontaneously.
Cavernous hemangiomascan be located in any area of the body, including skin, muscles, bones, structures of the central nervous system and parenchymal organs (most often in the liver, eye socket, etc.). More often they occupy deeper organs. Usually they are single, but in hereditary cases they can be multiple.
Cavernous hemangiomas may be a component of the genetic von Hippel-Lindau syndrome.
The less commoncavernous lymphangioma(lymphangioma cavernosum) also deserves attention. It usually develops in children around the neck, armpits, and occasionally retroperitoneally. Instead of blood, it is filled with lymph and can be of considerable size, which is clinically manifested as a visible tumor in, for example, the neck. At this location, they can perform in Turner syndrome.
Cavernous hemangioma: symptoms
Most patients are asymptomatic and show no symptoms. If present, they depend primarily on the location and size of the hemangioma. They may result from pressure on other structures or bleeding.
In the case of lesions located in the central nervous system, the patient may manifest:
- epileptic seizures,
- headaches,
- nausea and vomiting,
- visual disturbance,
- speech disorder,
- paralysis of limbs,
- imbalance,
- behavior change,
- mental disorders.
Cavernous hemangioma is the most common benign liver tumor. Some studies show that it can occur in up to one in five he althy peoplepersons. A patient with a change in this localization presents any symptoms very sporadically. If present, they are usually limited to non-specific pain and discomfort in the right upper abdominal quadrant. Spontaneous cracks are very rare and concern the so-called giant hemangiomas (over 5 cm).
Cavernous hemangioma is also the most common, benign neoplasm of the orbit in adults. It is characterized by slow growth, and the most typical symptom is painless progressive exophthalmia (most often one-sided). Other disorders that may arise from this localization include:
- feeling of "fullness" in the eye socket,
- hyperopia,
- disturbance of the function of the oculomotor muscles (impaired mobility of the eyeball),
- diplopia (double vision),
- visual acuity impairment,
- defects in the field of view.
Cavernous hemangioma: diagnosis
Due to the fact that the hemangioma causes ailments very rarely, it is often detected accidentally during imaging tests performed for other reasons. In the case of hepatic localization, the diagnostic test is ultrasound of the abdominal cavity. A more accurate assessment is possible thanks to computed tomography (CT), but the most sensitive and accurate examination in the case of cavernous hemangioma is magnetic resonance imaging (MRI). Assessment of hemangiomas is not the simplest. They can be confused with malignant tumors. Biopsy of a suspicious lesion that is actually a cavernous hemangioma may lead to bleeding.
Cavernous hemangioma: treatment
The treatment strategy depends to the greatest extent on the location and occurrence of symptoms. Asymptomatic cavernous hemangiomas detected in the brain are most often only subject to periodic control. They grow slowly and are unlikely to rupture. However, if it does occur, hemorrhage from the hemangioma usually does not wreak as much havoc as a ruptured aneurysm. The reason is the lower blood pressure in his cavity.
The implementation of only periodic control concerns changes in the vast majority of locations.
An interesting fact is that it is the condition after hemorrhage that can improve the conditions of the operation. The extravasated blood helps to separate the lesion from he althy brain tissue. Neurosurgery can be considered primarily in the case of large "bleeding" hemangiomas that cause neurological disorders, taking into account the benefit-risk balance of surgery. Surgery remains the mainstay of treatment of cavernous hemangioma in the CNS. There is also use for further researchradiotherapy as a safer alternative.
Also in the case of cavernous hemangioma of the liver, surgical treatment is performed in the case of giant, rapidly enlarging and symptomatic hemangiomas. The only thing that requires urgent surgery is rupture and bleeding into the peritoneal cavity, which is a life-threatening condition. Surgical treatment may be limited to the removal of the lesion itself or may involve a partial resection of the liver parenchyma.