When facing any vascular lesion present in the first
moments of life, it is necessary to determine whether
one is dealing with a tumour or a vascular malformation,
given the different evolution of both processes and,
hence, the different treatments they require.
Diagnosis is basically clinical, based on a correct
anamnesis and a detailed physical exploration. The
first thing is to establish whether the lesion was present
at birth and has changed size significantly, which
would lead one to think of a haemangioma or, on the
contrary, whether it is congenital and of very slow
growth, such as vascular malformations. Facing dubious
lesions, it is recommendable to carry out a biopsy
with immunohistochemistry for the GLUT-1 antibody,
specific to haemangiomas.
Amongst the image tests, the first choice is usually
ecography-Doppler, which makes it possible to determine
whether the lesion is of high or low flow and to
distinguish whether one is dealing with a haemangioma
or a vascular malformation. Depending on the type of
lesion, its localisation and degree of affectation it might
be necessary to carry out radiography, magnetic resonance,
phlebography, angio-resonance, arteriography
or lymphoscintigraphy to complete the study.
In more particular cases, such as multiple haemangiomatosis,
it is necessary to carry out an hepatic
echography, blood concealed in faeces, gastroscopy
and colonoscopy, as well a determination of thyroid
hormones; and in venous or combined extensive malformations,
a haemogram and coagulation tests.
On the other hand, the possible repercussions on
other organs make a multidisciplinary approach essential,
with the participation of different specialists.
Due to the wide spectrum covered by vascular
anomalies, treatment must be individualised
