In the vast majority of cases, the main causes of neoplasms in children are disorders in the development of tissues or internal organs during embryonic development.
As a rule, such formations as, for example, lymphangioma in children, are detected immediately after birth or in the first years of life. The most common tumors of connective tissue nature include hemangiomas and lymphangiomas. The growth of benign neoplasms in children occurs much faster than in adults, requires a quick diagnosis and the selection of a further treatment method.
What are benign tumors?
Benign tumors of the vascular tissue are divided into:
- vascular neoplasms (hemangiomas);
- vascular abnormalities (nevi, telangiectasia).
Hemangiomas (angiomas) occur due to impaired development of blood vessels. Their rapid growth is noted mainly in the first six months after the birth of the baby. In the process of proliferation, the angioma damages surrounding tissues, forming persistent cosmetic and functional defects.
The most common are capillary hemangiomas, consisting of many randomly located capillaries. They have a superficial location and do not damage the deep layers of the dermis. Upon examination, they are visualized as a flat or slightly above the skin spot with clearly defined boundaries of a bright red (less often cyanotic) shade. Prone to spontaneous involution up to 7-8 years. Favorite locations: head, face, upper back and chest.
Cavernous angiomas are formed by cavities separated by connective tissue jumpers. They are prone to germination in depth, affect subcutaneous fat and muscle tissue. They do not have clear boundaries. When located on the neck and face, they lead to their asymmetry and deformation. A characteristic feature is the increased blood supply to the angioma during screaming and crying.
Branched hemangiomas are formed by an accumulation of atypical vessels located, as a rule, on the lateral surfaces of the neck and face. The tumor pulsates, hot to the touch. Slow growth is noted, in comparison with other hemangiomas.
Mixed angiomas, consisting of vascular and other tissues, as well as combined, combining the signs of the above tumors, are rare.
Vascular tumor treatment
An absolute indication for the treatment of angiomas is considered to be ultrafast tumor progression, outstripping the development of the child, as well as dangerous localizations (parotid, orbital and temporal areas) and the presence of branching angiomas that are not prone to involution.
The tendency of angiomas to rapid growth in the first months of life is especially pronounced. A small, superficial formation within a few weeks can increase in size up to 3-4 times.
With small sizes of capillary and cavernous hemangiomas, conservative therapy "Propranolol" is used. Also effective:
- the introduction into the tumor of ethanol diluted with novocaine;
- hormonal sclerotherapy;
- cryodestruction;
- tumor excision;
- electrocoagulation;
- with branched angiomas, ligation of the supply vessels with further excision of the tumor.
Differential diagnosis of lymphangiomas and hemangiomas
What is the difference between hemangiomas and lymphangiomas in children? An angioma is the formation of a red or cyanotic shade, when punctured, blood is released. Characteristically enhanced blood filling of the hemangioma with crying and crying of the child, easily decreases when pressed, becomes paler when pressed with a glass.
Lymphangioma in children is characterized by a pale shade of the tumor, the release of light fluid in punctate, the absence of subsidence when pressed.
Benign neoplasms of the lymphatic vessels
How lymphangioma develops in children, the causes and recommendations for treatment are discussed below.
Lymphangiomas belong to dysembryogenetic tumors and are a violation of the development of the lymphatic system. In clinical practice, angiomas are less common.
As a rule, the diagnosis is not established immediately after birth, but after a few months due to the fact that initially the lymphangioma in children is in a dormant state, its active growth and increase occur as a result of traumatic injury, inflammation, and physiological growth of the child.
Favorite localizations are: the lateral surface of the neck, the bottom of the oral cavity, tongue, lips.
Rarely are lymphangiomas of the abdominal organs and secondary tumors arising from impaired lymphatic outflow (postoperative complications, lymphangitis).
Simple lymphangiomas (capillary)
Most often, lymphangioma in children manifests itself in the form of macroheilia (lip augmentation) and macroglosia (tongue enlargement). The appearance of multiple, closely spaced vesicles with cloudy, light contents is characteristic. The tumor has a testiform consistency, painless on palpation. In the absence of treatment, a lesion of the tongue leads to the formation of a malocclusion, an abnormal arrangement of teeth.
Cavernous lymphangiomas
On examination, multiple merging cavities and nodules with unclear contents are visualized. The tumor is localized in the soft tissues and leads to significant deformations of the neck and face.
Cystic lymphangiomas
It is characterized by clear boundaries, multicamera, and lymph migration from one cavity to another when the tumor is compressed. Neck lymphangioma in children is one of the common benign neoplasms and most often manifests itself on the side of the neck. Less commonly, cystic lymphangioma is localized in the oral cavity.
Lymphangioma infection
The onset of the inflammatory process is indicated by the rapid growth of the tumor, its pain on palpation, hyperemia, swelling of the skin and the appearance of general intoxication symptoms (fever, weakness, etc.).
If there is a cutaneous lymphangioma in a child, how to smear the tumor can be obtained from a specialist. Usually, antibacterial and anti-inflammatory ointments (Lincomycin, Clindamycin, Levomycol, erythromycin ointment), systemic antibiotic therapy, and antihistamines are used.
Treatment:
- Decompression puncture.
- Sclerosing therapy with quinine-urethane.
- Surgical excision and removal of pathological tissues.
- Combined treatment.
- Ultrasonic destruction with further aspiration of the contents.
Abdominal Lymphangiomas
The abdominal lymphangioma in children is manifested by the following symptoms. As a rule, patients are admitted to the hospital with a diagnosis of “acute abdomen” (acute appendicitis, mesodenitis, adnexitis, Meckel’s diverticulum). The main complaints of pain in the abdominal cavity, with large tumors, asymmetry of the abdomen is possible. Vomiting and stool disorders are not characteristic. On palpation, a dense, inactive formation, painless, not displaceable, is revealed.
For differential diagnosis, the use of ultrasound, computed tomography is informative. In the general analysis of blood there are no inflammatory changes characteristic of the “acute abdomen”.
Surgical treatment. A laparotomy is performed with excision of the neoplasm and its further histological examination.
Prevention
Children with benign neoplasms are subject to mandatory dispensary registration. After the treatment, regular examinations by the maxillofacial surgeon are recommended:
- during the first year - 1 time in three months;
- in the second year - twice a year;
- from the third year - after treatment once a year until reaching adulthood.
Treatment at the dentist is carried out in order to correct a pathological bite and at a speech therapist for speech correction.
Why does lymphangioma develop in children? The causes of the disease may be infections transferred during the period of embryonic development. There is no specific prophylaxis of hemangiomas and lifangiomas, since these neoplasms develop due to dysembryogenesis and are congenital.
When planning pregnancy, testing for TORCH infections is recommended (viruses that cause congenital abnormalities of the fetus: rubella, chickenpox, toxoplasmosis, cytomegalovirus, syphilis, herpes simplex virus types 1 and 2), giving up bad habits, taking special vitamin complexes, observation in a antenatal clinic and regular visit to the gynecologist.