In this section
Haemangioma, also known as a strawberry birthmark or strawberry naevus, is the most common tumour that occurs during childhood. Haemangiomas are usually not present at birth though there may be a small red mark at the site. Within one to four weeks of birth, they grow rapidly. They reach their peak size around four to twelve months of age before slowly going away (‘involuting’) over several years. Sometimes they go away completely, but more often they leave some mark on the skin. There are other, much less common forms of haemangioma, which can behave differently.
Vascular malformations are not as common as haemangiomas. They consist of abnormal concentrations of one or more types of blood vessel in one part of the body. We believe that they are generally present at birth. If they are underneath the skin, they may not be noticed until later in childhood when they may become painful or larger. Typically they do not grow in the way that haemangiomas do, but increase in size in proportion to the child as the child grows. If not treated they usually remain lifelong.
There are several different types of vascular malformation:
Some vascular malformations have in the past incorrectly been called ‘haemangiomas’. All specialists in birthmarks use consistent names but many doctors who work in other areas will still call a vascular malformation a ‘haemangioma’. The problem of differing names for vascular anomalies is discussed below.
There are a range of different treatments available for both haemangiomas and vascular malformations. These include drug treatments, laser, surgery and injection treatment by interventional radiologists. The exact treatment depends on the nature of the condition and treatment decisions are often complex. Sometimes more than one treatment may be appropriate, so choosing the best treatment requires consultation between different specialists. For this reason, children with vascular anomalies are often managed by a multidisciplinary team of specialists who provide a dedicated service for the treatment of vascular anomalies.
In many large cities it is possible to find a multidisciplinary team managing vascular anomalies. In Melbourne, the multidisciplinary team is based at the Royal Children’s Hospital. Members of the team also work in other hospitals where adults and children can be treated. The full team meets at the Royal Children’s Hospital each month, and regularly discuss cases and plan treatment at other times.
The Royal Children’s Hospital, Melbourne team includes:
Referrals to the clinic need to be made in writing or by email by a medical practitioner.
Other Multidisciplinary teams in Australia are located at:
Parents of children with vascular anomalies have told us that looking at pictures of other children with vascular malformations on the internet have been among their most distressing experiences. No two children with a vascular malformation look the same. When doctors put pictures of children with vascular malformations on the internet they often choose the most dramatic looking pictures which are not representative of the overall spread of cases. Many parents assume that their child’s condition may progress to look like the worst pictures they have seen but this is not the case. Seeing pictures of other children does not tell you how your child will look. We believe that showing pictures creates more confusion for parents than it provides information and have decided not to show pictures on our website. It is best to discuss with your own doctor what the future may hold. Sometimes there may be a place for seeing carefully selected photographs, but even these will not give a perfect guide to the future.
Even a brief search on the internet will show that there is a lot of variation in what names are used to refer to the many different vascular anomalies. Sometimes different doctors use different names to talk about one condition. This occurs even in scientific articles and radiology or pathology reports. This is not only very confusing for parents, it also could hold back the development and use of the best treatments. The International Society for the Study of Vascular Anomalies (ISSVA) has an accurate and precise naming system which is used on this site and by other expert groups internationally. Many doctors still like to use older terms, partly because they are used to them, partly because they like the history attached to the old names (many go back to the famous nineteenth century German pathologist Rudolph Virchow). Many doctors still do not know about the new system.
ISSVA is the international group which brings together experts from around the world every two years to discuss, exchange information and develop new treatments for vascular anomalies. It maintains communication between all expert centres worldwide so that all centres are aware of the results being achieved elsewhere with new and developing treatments. ISSVA has an up to date system of names for vascular anomalies which ensures that doctors who treat vascular anomalies all speak the same language. We strongly support the use of the ISSVA classification of vascular anomalies. If your treating doctor is not a member of ISSVA, ask them why not!