Vascular Anomalies Program
The Vascular Anomalies Program at Children's Hospital Los Angeles treats children who have abnormally developed blood vessels, including arteries, veins, capillaries and lymphatic channels. These are sometimes referred to as "vascular birthmarks."
The most common reasons for children to be referred to our Center are:
- Vascular Tumors
Vascular tumors are rare conditions that can present in a spectrum from benign to malignant (cancerous). Some of the more notable types of vascular tumors are described below. Treatment of these conditions often requires collaboration with an oncologist.
- Epitheliod hemangioendothelioma
- Kaposiform Hemangioendothelioma
- Tufted angioma
Epithelioid hemangioendotheliomas are rare vascular tumors that may occur anywhere in the body, including bones, liver, and lungs. They are characteristically low-grade malignant tumors that grow slowly and have small potential for invading surrounding tissues or metastasizing to other parts of the body. As with hemangiopericytomas, surgical excision, radiation therapy, and/or chemotherapy are the available treatments.
Hemangiopericytomas are rare vascular tumors that occur mostly in adults and can be benign or malignant. They tend to occur in deep locations within the body, commonly in bones. When present in an infant, they are usually benign and go on to regress on their own. They are often discovered quite late when their large size leads to effects on the surrounding tissues. Malignant varieties of the tumor may metastasize to other parts of the body, usually the lungs. Treatment consists of surgically resecting the mass and surrounding tissues, amputation, radiation therapy, and/or chemotherapy.
Kaposiform Hemangioendothelioma (KHE)
KHE is a rare vascular tumor that can occur prior to or shortly after birth. They typically occur on the trunk or on parts of extremities located near the trunk. The appearance of skin that is involved with KHE is a deep purple or red color with a tense, shiny texture. They may appear bruise-like in certain areas adjacent to the tumor. One of the notable and most serious potential complications is the Kassabach-Meritt phenomenon, which is a bleeding disorder characterized by trapping of platelets within the tumor and depletion of other clotting factors. Treatment of KHE often requires steroid therapy and sometimes a chemotherapeutic agent called vincristine. Certain locations of KHE are related to high mortality rates.
Tufted angioma is a rare vascular tumor, usually of early childhood. Small red or purple patches appear on the skin of the upper body and neck. These can be quite extensive in some patients. Kassabach-Meritt phenomenon may occur with large tufted angiomas, which can lead to life-threatening bleeding complications. These tumors, however, grow slowly and are very similar to kaposiform hemangioendothelioma.
Vascular anomalies can be difficult to accurately diagnose and treat. Approximately half of patients are misdiagnosed. One third are given inappropriate treatment. Our team ensures the best possible outcome by combining the expertise of specialists and tailoring treatment for each patient.
Vascular Anomalies Clinic
We currently hold three interdisciplinary clinics each month on Wednesdays. Our clinic approach:
- Gives patients the convenience of being seen by more than one specialist during the same visit
- Enables subspecialists to share their assessments and concerns with one another
- Allows our team members to share assessment outcomes with patients and family members jointly
Although both hemangiomas and vascular malformations may be similar in appearance, they are treated very differently.
Identification and diagnosis of the lesion is based on the history reported by the patient or family, physical examination and radiologic testing.
Testing to determine the exact type of lesion can include magnetic resonance imaging (MRI), angiography and/or a specialized ultrasound exam.