What to know about internal hemangiomas
Hemangiomas usually occur on the skin of infants, presenting as a red mark. However, they occasionally develop in internal organs, including the brain and liver.
They rarely cause symptoms, and people may not be aware they have an internal hemangioma until they have a scan for an unrelated condition.
This article explains the types, symptoms, and treatments for internal hemangioma.
Hemangiomas can develop in many internal organs, including the liver and brain.
Internal hemangioma can occur on the liver but often causes few or no impact on overall health when small.
Image credit: James Heilman, MD, 2012 - A liver hemangioma
Internal hemangiomas in the liver are usually small and do not produce any symptoms.
However, liver hemangiomas that are larger than 4 centimeters (cm) or about 1.6 inches across can cause noticeable signs, such as discomfort or a feeling of fullness in the stomach.
In rare instances, symptoms might include weight loss and nausea.
Pain may occur if the tumor bleeds or leads to a blood clot.
Vascular tumors, or growths that develop from blood vessels, are rare in the brain. All brain tumors are uncommon, and brain hemangiomas make up a small proportion of these.
Two types of hemangioma occur in the brain:
Hemangioblastomas are slow-growing benign tumors that develop from the overgrowth of the cells that form the inside layer of blood vessels.
About 2 percent of all the tumors that develop in the brain are hemangiomas. These usually occur on the brain stem and cerebellum, which are the centers for automatic processes in the body, such as breathing and the coordination of movement.
People who have a genetic condition known as von Hippel-Lindau syndrome, which causes an overgrowth of tumors throughout the body, tend to develop hemangioblastomas more often than other people.
As well as developing hemangiomas in the brain, people with this disorder may also develop hemangiomas in the back of the eye, as well as cysts in the liver, pancreas, and kidneys.
These types of hemangiomas are rarer than hemangioblastomas. They are higher-grade tumors that most likely grow from an overgrowth of the cells around blood vessels in the meninges. The meninges are membranes that cover the brain or spinal cord.
Hemangioblastomas can eventually spread to other parts of the body.
Most internal hemangiomas do not need treatment.
However, anyone who has a hemangioma should have regular check-ups, so that their doctor can monitor any changes in the tumor.
Although most of these tumors are harmless and many people will never know they have one, some hemangiomas do require treatment.
Sometimes, doctors will recommend treatment if a hemangioma presses on an organ, reduces a person's bodily functions, or causes pain or other physical symptoms.
Treatments often include surgery to remove the hemangioma.
Where possible, surgeons will remove a problematic brain hemangioma. However, if complete removal is not possible, they may also apply a form of focused radiation.
Surgeons only remove liver hemangiomas if the symptoms give particular trouble, or the benign tumor is growing at an accelerated rate.
Some hemangiomas grow back after removal, unlike other benign growths, which do not return after surgery.
Large liver hemangiomas in infants can lead to heart issues due to their effect on blood vessels. In these instances, a doctor will consider steroids, heart medication, surgical removal, and, in rare cases, radical liver surgery.
Research into a class of medications that can help prevent the formation of new blood vessels, known as anti-angiogenics, is ongoing. These drugs may prove helpful in treating internal hemangiomas.
Causes and risk factors
Researchers do not yet know what causes internal hemangiomas.
However, they have identified some risk factors that can increase the chances of developing the tumor.
Around 1 in 10 people who have hemangioblastoma in the brain also have a disease called Von Hippel-Lindau syndrome.
Hemangioblastoma tends to occur in people over 40 years of age. Hemangiopericytoma, on the other hand, is more common in younger people.
This type of tumor is more common in women than in men.
While they are uncommon, internal hemangiomas most often occur in the liver and brain.
Internal hemangiomas are rare overall, and problems only occur in a small number of cases. A doctor will often discover a hemangioma while diagnosing an unrelated condition.
A doctor may be able to feel a lump in some cases and can find an internal hemangioma using the following scans:
- CT scans
- MRI scans, which are more likely to identify the soft lumps of hemangioma
- angiogram, in which the doctor injects dye into the blood vessels to highlight the hemangioma, then takes an X-ray
Hemangiomas are benign growths that most commonly occur on the skin of newborn infants but can also grow inside the body. Many will never require treatment and do not cause symptoms.
Some, however, have a risk of developing into cancer. A person with an internal hemangioma may require regular checkups.
If the hemangioma presses on an organ, causes pain, or interferes with normal function, the doctor may remove the hemangioma through surgery.
The hemangioma may grow back following removal. However, they rarely cause health problems and many people will never know they had the growth.