The most common non-cancerous (benign) soft tissue tumor in kids is a hemangioma. This is a tumor that is formed from the cells of blood vessels. Hemangiomas that are on the surface of the skin are often called ‘birthmarks’ because they are present at birth or start to appear during the first few months of life. The most common sites for hemangiomas are the skin of the face, scalp, trunk and extremities but, because they are made of cells that form blood vessels they can be found in deeper tissues.
Because they are so superficial diagnostic testing isn’t usually needed for hemangiomas - their appearance is diagnostic. A deep hemangioma may be seen on an MRI that was requested for a work-up of a condition that wasn’t as apparent. If a deep hemangioma is found, further testing like an angiogram may be needed to show the extent of the tumor or if it’s pressing on other vital structures or affecting blood flow.
Hemangiomas usually decrease in size as a child gets older so often no treatment is necessary. If they become painful a non-steroidal anti-inflammatory drug like aspirin or ibuprofen may be recommended as well as light compression by using a compression stocking or ace wrap.
Some hemangiomas can become quite painful, affect blood supply, or continue to grow. If this is the case then more aggressive management is often considered. Surgery may be recommended to remove a painful hemangioma. A hemangioma that cannot be removed surgically but is continuing to grow can be treated using a procedure called embolization. During an embolization procedure the blood vessel into the tumor is ‘plugged’ to stop the growth of the tumor. Another option may be sclerotherapy, where the blood vessel into the tumor is injected with alcohol to cause the vessel to scar and collapse. Sometimes this requires multiple treatments to be effective. Fortunately most hemangiomas don’t require treatment and can be monitored to assure a more aggressive process isn’t occurring.