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Special Section of JCS Addresses Vascular Anomalies

Hemangiomas, vascular tumors, and other vascular (blood vessel-related) anomalies are potentially disfiguring lesions that cause distress // for affected children and their parents and confusion among physicians and surgeons. Although advances have been made in the diagnosis and treatment of these lesions, many myths, misconceptions, and inaccuracies remain.

To address this situation, the editors of The Journal of Craniofacial Surgery, in collaboration with the American Association of Pediatric Plastic Surgeons, have invited leading international experts to share their views on the current concepts and controversies in treating children with vascular anomalies. The results appear in a Special Section of the July/August issue of JCS.

Over the years, physicians and surgeons have held widely divergent, often inaccurate views regarding vascular anomalies, according to an introductory editorial by Dr. Mutaz B. Habal, Editor of JCS. Hemangiomas, the most common vascular anomaly, are vascular "birthmarks" that can enlarge rapidly. Because many hemangiomas are located on the head and neck, they may cause serious cosmetic problems. Depending on location, damage to the eye or other structures can also occur.

A major problem is that many doctors have been taught that all hemangiomas "will disappear within a short time." However, Dr. Habal writes, "This is absolutely not true…These vascular tumors do not disappear like magic." Some hemangiomas do shrink over time, but may leave behind an area of baggy skin. Others grow very large, causing serious disfigurement if untreated. For many patients, this widespread misconception has led to delays in treatment, cosmetic and psychological issues for the child, and problems with scarring when surgery eventually is performed—not to mention a "windfall for litigation," according to Dr. Habal. Confusion over diagnosis leads to inaccurate identification of vascular tumors and further delays in treatment. <
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