Koka Kirthi, Zeppieri Marco, Patel Bhupendra C.
Sankara Nethralaya Chennai
University Hospital of Udine, Italy
Capillary infantile hemangiomas are the most common benign orbital neoplasms in children. Historically, they have been referred to by many names, such as infantile hemangiomas, juvenile hemangiomas, hemangioblastomas, or strawberry nevi, because of their characteristic red color. Currently, the universal vocabulary of capillary hemangioma is followed. A fast development phase and spontaneous involution distinguish them. John Mulliken and Julie Glowacki initially classified these vascular anomalies as angiomas in a study published in 1982. They were thought to be proliferating lesions with an independent life cycle. However, these classifications have undergone several revisions. Capillary infantile hemangiomas have been reclassified as benign vascular neoplasms under the revised International Society for the Study of Vascular Anomalies (ISSVA). According to this classification, capillary infantile hemangiomas are benign neoplasms, which are true tumors that arise de novo and undergo clonal proliferation and growth that is out of proportion to the patient. These lesions have a predictable life cycle and most often do not require any treatment without complications. Although they can develop anywhere on the body, capillary infantile hemangiomas most frequently occur in the head and neck region, accounting for up to 60% of cases. These tumors are made up of anastomosing capillary-sized blood vessels with endothelial cells lining them and pericytes supporting them. Deeper lesions can appear bluish from deoxygenated blood, while superficial lesions have bright red nodules. Most infant hemangiomas are isolated lesions, while some, eg, hepatic hemangiomas, may have several lesions that indicate systemic involvement. Capillary infantile hemangiomas typically show symptoms in the first few weeks of life. They usually multiply quickly over the next 3 to 12 months and progressively enlarge. Following this, capillary infantile hemangiomas start a gradual involution process that causes the lesion to shrink and usually leaves behind leftover fibrotic or fatty tissue. While most lesions resolve independently, they might result in telangiectasia or residual scarring. Hemangiomas can occasionally result in issues that call for medical attention.
毛细血管瘤是儿童最常见的眼眶良性肿瘤。在历史上，由于其特征性的红色，它们有许多名称，如婴儿血管瘤、青少年血管瘤、血管母细胞瘤或草莓状痣。目前，遵循毛细血管瘤的通用术语。快速发展阶段和自然消退是其特点。1982年约翰·穆利肯和朱莉·格沃茨基在一项研究中最初将这些血管异常归类为血管瘤。它们被认为是具有独立生命周期的增殖性病变。然而，这些分类已经历了几次修订。根据修订后的国际血管异常研究学会（ISSVA），毛细血管瘤已被重新归类为良性血管肿瘤。根据这一分类，毛细血管瘤是良性肿瘤，是真正的肿瘤，起源于新生，经历克隆增殖和生长，与患者身体比例失调。这些病变有可预测的生命周期，大多数情况下，没有并发症时不需要任何治疗。尽管毛细血管瘤可发生于身体任何部位，但最常见于头颈部，占病例的60%。这些肿瘤由相互吻合的毛细血管大小的血管组成，血管内衬有内皮细胞，周围有周细胞支持。较深的病变因脱氧血液而呈蓝色，而浅表病变有鲜红色结节。大多数婴儿血管瘤是孤立性病变，而一些，如肝血管瘤，可能有多个病变，提示全身受累。毛细血管瘤通常在出生后的头几周出现症状。在接下来的3至12个月内，它们通常迅速增殖并逐渐增大。此后，毛细血管瘤开始逐渐消退过程，导致病变缩小，通常留下剩余的纤维化或脂肪组织。虽然大多数病变可自行消退，但可能导致毛细血管扩张或残留瘢痕。血管瘤偶尔会导致需要医疗关注的问题。
