Adams Denise M, Lucky Anne W
Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, Cincinnati, Ohio 45229, USA.
Semin Pediatr Surg. 2006 May;15(2):124-32. doi: 10.1053/j.sempedsurg.2006.02.010.
Before the early 1980s, the lack of an accepted system of nomenclature for vascular anomalies created confusion and frustration for clinicians and patients alike. Scientific advances over the past two decades have, however, led to international consensus among experts on a system of disease classification that comprises vascular tumors and vascular malformations. The most common vascular tumor is hemangioma, which is frequently seen in the head and neck area. Some hemangiomas are best left untreated, whereas others may cause significant complications and disfigurement, thus requiring intervention. Early recognition and treatment of complications is imperative. This is best accomplished in an interdisciplinary setting, where collaborative treatment strategies are planned on an individual basis. Steroids are the first line of medical treatment. Chemotherapy with vincristine is an effective treatment for complicated lesions, although it requires further evaluation through prospective clinical trials. Because of known neurotoxicity, interferon is used as a last resort, especially in children younger than 1 year of age. Laser therapy and surgical excision are also important therapeutic modalities. This article presents an overview of hemangiomas and other vascular tumors, highlighting cervicofacial lesions and describing critical and underappreciated clinical presentations.
在20世纪80年代早期之前，由于缺乏一个被广泛接受的血管异常命名系统，临床医生和患者都感到困惑和沮丧。然而，过去二十年来的科学进展使得专家们就一种疾病分类系统达成了国际共识，该系统包括血管肿瘤和血管畸形。最常见的血管肿瘤是血管瘤，常见于头颈部区域。一些血管瘤最好不予治疗，而另一些可能会导致严重的并发症和毁容，因此需要进行干预。必须尽早识别并治疗并发症。这在跨学科环境中最容易实现，在这种环境中，会根据个体情况制定协作治疗策略。类固醇是一线药物治疗方法。长春新碱化疗对于复杂病变是一种有效的治疗方法，不过需要通过前瞻性临床试验进行进一步评估。由于已知的神经毒性，干扰素是最后的治疗手段，尤其对于1岁以下的儿童。激光治疗和手术切除也是重要的治疗方式。本文概述了血管瘤和其他血管肿瘤，重点介绍了头颈部病变，并描述了关键且未得到充分认识的临床表现。
