Nasal hemangioma is the most common benign neoplasm in the face. This tumor is often found in children and adults. It not only spoils the appearance of a person, but can also adversely affect his he alth. Why are hemangiomas dangerous? And should they be removed? We will answer these questions in the article.
Description
Nasal hemangioma is a neoplasm consisting of pathologically altered vascular tissue. These tumors never turn into cancer, but can grow quite quickly.
Most often, hemangiomas occur in infants and the elderly. In women, such neoplasms appear more often than in men. The tumor is formed due to the excessive growth of blood vessels, which cease to provide blood circulation at the site of the lesion.
Unlike other types of neoplasms, hemangiomas can disappear on their own. However, you should not completely rely on such an outcome. Spontaneous regression of the neoplasm is not always observed. Vascular tumor can not onlyspoil the appearance of the patient, but also adversely affect the various functions of the body.
Varieties
Doctors classify these neoplasms according to their structure. The following types of nasal hemangioma are distinguished:
- Capillary. This type of tumor is formed from dilated small vessels overflowing with blood. The neoplasm is localized shallow under the skin and usually has a small size (several millimeters). Capillary hemangiomas most often appear on the tip and wings of the nose.
- Cavernous. Such a hemangioma is formed from large vessels. The tumor consists of several segments filled with blood. The hemangioma cavities communicate with each other with the help of vascular bridges. This type of tumor is located in adipose tissue. Cavernous hemangiomas are more common in older people.
- Combined. This is a fairly rare, but the most severe type of hemangioma. Such a tumor consists of both small and large vessels. The upper part of the neoplasm is located under the skin, and the lower part consists of several cavities and is localized in fatty tissue.
International Classification of Diseases
According to ICD-10, hemangioma refers to benign neoplasms. Such pathologies are designated by codes D10 - D36. Tumors consisting of blood and lymph vessels are classified as a separate group (D18). The full ICD-10 hemangioma code is D18.0.
Causes of appearance in children
Vascular tumors occur in approximately 10% of infants. They are not genetic, butare laid down in the intrauterine period. The cause of hemangioma in newborns are various adverse effects on the fetus. These include:
- viral respiratory infections in a pregnant woman in the first trimester;
- eclampsia;
- hormonal disorders in expectant mother;
- use of drugs, alcohol, and smoking during the gestation period.
Vascular tumors are more common in low birth weight premature babies. The risk of hemangioma in a baby increases if the age of the expectant mother is older than 37-38 years.
Causes of neoplasms in adults
Nasal hemangioma in adult patients most often occurs in old age. It is a consequence of acquired changes in the structure of blood vessels. The following factors can provoke the appearance of a tumor:
- pathologies of internal organs, accompanied by vascular disorders;
- injuries to the nose;
- frequent respiratory infections;
- allergic reactions;
- irritation of the nasal mucosa;
- excessive sun exposure;
- intranasal drug use.
Symptomatics
If the hemangioma of the nose is located on open areas of the skin, then usually it does not affect the general well-being of a person. This neoplasm can only be determined by changes in the epidermis in the affected area. External manifestations depend on the type and structure of the tumor.
Capillarynasal hemangioma initially looks like a flat red spot. Over time, it grows, becomes convex and acquires a purple-purple color. The boundaries of the neoplasm are always clearly defined, and the surface is smooth. If you press hard on the tumor, then its color becomes much paler.
A cavernous hemangioma at the tip of the nose looks like a bumpy convex formation of blue or purple. Outwardly, the tumor is a bit like a grape. It can also be localized in the subcutaneous tissue of the wings and sinuses. When you press it, a dent is formed. During physical exertion, there is a rush of blood to the hemangioma, and the tumor becomes larger.
Combined hemangioma can look very diverse. The appearance of a mixed tumor depends on the predominance of capillary or cavernous elements in its structure.
Hemangiomas of the nasal cavity are much more severe than tumors located on open areas of the skin. Such neoplasms can close the lumen of the nasal passages and significantly complicate breathing. This is accompanied by the following symptoms:
- feeling stuffy in the nose;
- frequent runny nose;
- unexplained nosebleeds.
In advanced cases, hearing loss may occur. The appearance of such a symptom means that the tumor has grown into the nasopharynx and blocked the mouth of the auditory tube.
In large hemangiomas of the nasal septum, patients often havenoisy breathing and snoring during sleep. In addition, the neoplasm constantly irritates the mucous membrane. This is accompanied by a runny nose, sneezing and a reflex cough. Against the background of breathing difficulties, increased fatigue and headaches appear due to oxygen deficiency in the body.
Danger
How dangerous are hemangiomas? As already mentioned, these tumors never undergo malignant transformation. However, vascular neoplasms can grow from the skin and fatty tissue into nearby tissues and organs. Such uncontrolled growth is especially characteristic of combined hemangiomas.
If the tumor is localized inside the nose and its size exceeds 0.5 cm, then it significantly complicates breathing. Such a neoplasm can cause blood clots and infection of the blood.
If the hemangioma is located on the outer skin, then it is dangerous only when it grows to a large size. The larger the tumor, the easier it is to accidentally injure it. Damage to the neoplasm is accompanied by rather heavy bleeding.
Only a specialist can assess the potential danger of hemangioma and decide on the need to remove the tumor. Therefore, if raised spots of red or purple color appear on the skin, it is necessary to visit a dermatologist.
Diagnosis
If the hemangioma is located on the outer parts of the nose, then its diagnosis is not particularly difficult. This tumor can be identified during an external examination of the patient. However, in some cases, hemangioma mayresemble other neoplasms in appearance. To establish its structure, the doctor may prescribe an ultrasound diagnosis. This examination shows a capillary or cavernous appearance of the tumor.
When the neoplasm is localized inside the nasal cavity, an examination by an otolaryngologist is necessary. X-rays and angiography with a contrast agent are also prescribed. These examinations reveal changes in the soft tissues and impaired blood flow due to the appearance of a hemangioma. If there is doubt about the good quality of the tumor, a biopsy is prescribed.
Conservative Therapy
When a hemangioma appears on the nose of a child or an adult, doctors most often recommend dynamic monitoring. Indeed, in many cases, such neoplasms resolve on their own. It is necessary to visit the doctor periodically. The specialist will monitor the condition and growth of the neoplasm.
If the tumor is located on the outer part of the nose, then when it grows, drug treatment is most often used. Drug therapy is also necessary if the hemangioma is large and looks like a serious cosmetic defect.
For the pharmacological treatment of hemangiomas, the drug "Propranolol" is most often used. This remedy is especially effective in capillary tumors. This medicine is available in the form of tablets and belongs to beta-blockers. It constricts the blood vessels in the affected area. As a result, the hemangioma turns pale, its cells die, and growth stops.
Timolol drops are also used. This is a local remedy for the treatment of eye diseases, but it is also used in the treatment of vascular tumors. The solution is applied directly to the affected area. It works in the same way as Propranolol. Currently, the drug is also produced in the form of a gel under the trade name "Oftan Timogel".
Another medical treatment option is sclerotherapy. An ethanol solution or "Fibro-Vayne" preparation is injected into the tumor cavity. This helps stop the nutrition of tumor cells. Gradually, the neoplasm completely dies off. In no case should this method of treatment be used independently; this can lead to extensive tissue necrosis. Sclerosing therapy is carried out only on an outpatient basis. This is a rather painful method, so it is used mainly in the treatment of adults.
Surgical methods
In some cases, the hemangioma has to be removed surgically. There are the following indications for surgery:
- localization of the tumor inside the nasal cavity;
- frequent bleeding;
- breathing difficulties;
- increased risk of neoplasm trauma;
- accelerated tumor growth.
When detecting a hemangioma on the nose in newborns, dynamic observation is usually prescribed for 2 years. If the tumor not only does not disappear during this time, but also grows, then thisis an indication for surgery. However, if the neoplasm interferes with normal breathing, then surgical intervention is carried out urgently.
Below you can see a photo of the child before and after removal of the hemangioma.
Excision of a hemangioma with a scalpel is rarely used these days. This is a rather traumatic operation, after which a noticeable scar remains on the skin. Currently, the removal of the neoplasm is carried out in more gentle ways:
- Laser cauterization. This is an almost painless method. Under the influence of laser beams, the tumor resolves. After treatment, there are practically no traces left on the skin. However, it is very rare to remove a hemangioma in one procedure. At least 3 - 5 sessions are required to completely get rid of the tumor.
- Electrocoagulation. The tumor is cauterized with high-frequency currents using a special device. This is a quick way to get rid of neoplasm. Usually it is possible to remove a hemangioma in one session. However, after the procedure, a scar may remain on the skin.
- Liquid nitrogen. The cauterization procedure takes only a few seconds. Under the influence of low temperatures, hemangioma cells are destroyed, and the tumor disappears. A small wound remains on the affected area, which heals within 10 - 14 days.
The above methods allow you to radically get rid of hemangioma. Tumor recurrences are extremely rare. In most cases, they are associated with poor-quality removal of the neoplasm.
