Cavernous Hemangioma: Causes, Symptoms, Treatment and Cost

Cavernous hemangioma is a kind of benign tumor that grows from blood vessels. It is made up of small and large, dilated, thin-walled blood vessels and can vary in size from one millimeter to several centimeters. It usually involves the skin, mucous membranes or internal organs.

There are three types of cavernous hemangioma: superficial, deep, and capillary.

• Superficial cavernous: Superficial cavernous hemangiomas are the most common type, appearing as a red or blue bump on the skin’s surface.
• Deep cavernous hemangiomas: Deep cavernous hemangiomas are located beneath the skin and can be more difficult to diagnose.
• Capillary cavernous hemangiomas: Capillary cavernous hemangiomas are smaller than other types and can appear as tiny red spots.

The exact cause of the tumor remains unknown; however, some theories suggest it may be linked to genetic defects or environmental triggers due to the presence of risk factors such as radiation exposure, prior surgery, smoking history, and advanced age.

Other possible causes include intrauterine events such as vascular malformations induced by high-dose estrogen or low-dose potassium during pregnancy.

• Generally, no symptoms at all until Hemangiomas grow large or occur in delicate parts of the body.
• Symptoms include pain, tingling sensation, and localized swelling in the area where the Hemangioma is located.
• Skin discoloration may be present due to a black, purplish or blue bump on the skin surface in some cases.
• In extreme cases, difficulty breathing and coughing up blood if Hemangiomas affect respiratory passages like lungs and trachea can arise as well.

• Cavernous hemangioma is a benign tumor, so it is not possible to prevent it from developing.
• To reduce the risk, practice healthy lifestyle habits such as quitting smoking, avoiding alcohol, getting regular exercise and eating a balanced diet with plenty of fresh fruits and vegetables.
• Minimizing exposure to certain chemicals and pollutants found in cosmetics or other products can also help lower the risk of developing this type of tumor.

• Physical Examination: A physical examination of the affected area is the first step in diagnosing a cavernous hemangioma. Your doctor may look for signs of swelling, discoloration, or other changes in the skin, and may also feel for any lumps or bumps near the affected area.
• Ultrasound: Ultrasound is a noninvasive imaging technique that employs sound waves to make pictures of inside body structures. It can be used to diagnose a cavernous hemangioma by detecting any abnormal vascular patterns that are present in the affected area.
• Magnetic Resonance Imaging (MRI): MRI is an imaging method that employs powerful magnetic fields and radio waves to provide detailed pictures of inside body structures. It can be used to detect a cavernous hemangioma by detecting any abnormal vascular patterns that are present in the affected area.
• CT Scan: A CT scan is an imaging procedure that employs X-rays to provide detailed pictures of inside body structures. It can be used to detect a cavernous hemangioma by detecting any abnormal vascular patterns that are present in the affected area.
• Biopsy: During a biopsy, a tiny sample of tissue is removed surgically and viewed under a microscope. A biopsy is usually required to confirm a diagnosis of cavernous hemangioma.

• Hepatic Enlargement: Patients with cavernous hemangioma can experience an enlargement of the liver due to the presence of large tumors in the organ.
• Rupture: Cavernous hemangiomas can also rupture, leading to internal bleeding and possibly death if left untreated.
• Abdominal Pain: Patients may experience pain in the area around the tumor caused by inflammation or pressure on surrounding organs from the growth’s size and weight.
• Swelling: Swelling of the abdomen can occur if there is a major rupture or multiple smaller ones causing blood accumulation beneath the skin surface.
• Jaundice: Jaundice can be seen in some individuals due to obstruction of bile ducts by large tumors pressing against them and impeding bile flow.
• Metastasis/Spread to Other Organs: In rare cases, cells from a cavernous hemangioma can spread to other organs, causing secondary tumors that may further complicate care if not caught and treated in time.

• Amla: Extract the juice from Indian gooseberry (amla). Mix one teaspoon of this juice with one teaspoon each of honey and aloe Vera gel, and drink the mixture once or twice a day for several months.
• Garlic: Make sure to include lots of garlic in your diet. Garlic has anti-inflammatory properties which can reduce the growth of hemangiomas naturally over time.
• Neem: Make sure to include neem leaves and amalaki fruits in your diet as these have anti-viral properties that fight against infection caused by hemangiomas, thereby helping to reduce their size over time.
• Nardhi Oil: Massage nardhi oil onto and around the affected area twice a day for several months, as it has wound healing properties which helps soothe irritation around hemangioma scars and promote their gradual fading away over time.

• Eating a balanced, nutrient-rich diet is important for individuals with cavernous hemangioma.
• Antioxidant-rich foods, such as fruits and vegetables with vibrant colours, whole grains, lean sources of protein, and healthy fats, should be consumed.
• Incorporating plenty of water into the diet along with herbal teas may also be beneficial to help reduce inflammation associated with the condition.

• Avoid foods high in salt, sugar and saturated fats, such as processed meats, fast food and fried foods.
• Limit processed carbohydrates such as white flour and white rice.
• Restrict alcohol intake and avoid smoking.
• Steer clear of caffeine-containing products like coffee or energy drinks.

• Surgical excision: Surgical excision is the primary treatment for cavernous hemangioma and is typically recommended for patients who are experiencing serious symptoms or complications from the condition.
• Radiation therapy: Radiation therapy may be considered in some cases as a way of controlling growth and reducing discomfort associated with larger lesions.
• Embolization: This procedure involves injecting small particles into the blood vessels that feed the hemangioma in order to cut off its blood supply and shrink it over time.
• Laser therapy: This type of treatment uses intense beams of light to destroy abnormal veins and capillaries that feed the tumor, reducing its size over time without damaging healthy tissue around it.

A patient with a suspected case of Cavernous Hemangioma should consult a doctor specializing in the diagnosis and treatment of blood vessels (Angiologist).

They may also need to consult specialists from other related medical fields, such as neurology or oncology, depending on their symptoms and needs.

• Interferon alpha: Interferon alpha is a medicine used for the treatment of cavernous hemangiomas. It works by stimulating the production of proteins that inhibit the growth of cells that form the hemangioma. Examples of interferon alpha medications include Pegasys and Roferon-A.
• Corticosteroids: Corticosteroids are medications used to reduce inflammation and help slow down the growth of hemangiomas. Examples include prednisone and dexamethasone.
• Propranolol: Propranolol is a type of beta blocker used to reduce blood flow to the hemangioma, thereby reducing its size and appearance. Examples include Inderal, Innopran XL, and Inderide LA.
• Vincristine: Vincristine is a chemotherapy drug used to treat certain types of cancer, but it has also been found to be effective in treating cavernous hemangiomas in some cases. Example - Oncovin.

The length of time required to recover from Cavernous Hemangioma varies on the condition's severity and the treatment options used. Generally, it takes a few weeks to recover from the surgery, and full recovery could take up to 3-4 months.

No, the effects of treating a cavernous hemangioma do not last forever. The treatment can make the tumour smaller and stop it from growing, but it is not a cure. The tumors can recur or even grow back after treatment.

The following post-treatment guidelines are recommended for patients with cavernous hemangiomas:

• Follow-up medical appointments to monitor the growth of the hemangioma and any symptoms it may be causing.
• Avoiding contact sports and other activities that might harm the damaged region.
• Maintaining a healthy diet and lifestyle to encourage recovery and avoid additional issues.
• Managing pain and other hemangioma-related symptoms by taking medicine as directed by a doctor.
• Wearing sunscreen when outside to protect the affected area from sun damage.

On average, a small procedure like open biopsy can cost up to 2,500 Rupees, while more complex treatments like embolization and sclerotherapy can reach up to 25,000 Rupees or more.

In addition, hospitalization costs along with other medical expenses for medications and tests are also likely to be associated with the treatment.

• Side effects from Cavernous Hemangioma treatments often include swelling and discomfort at the site of injection or surgery, as well as a risk of infection.
• Minor, temporary side effects such as numbness, tingling, or scarring may also occur after treatment.
• Radioembolization is associated with additional risks including nausea, vomiting, abdominal pain, and changes in liver function tests.
• Rarely, cavernous hemangiomas can cause more serious long-term health problems such as stroke or seizures if not treated appropriately.

If you have any Cavernous Hemangioma issues, you should see a doctor right away since they may lead to complications like 'Hepatic Enlargement, Rupture, and Jaundice,' for which treatment regimens can range in length from a few months to years, depending on the situation.