Hemangioma of the nose is the most common benign neoplasm in the face. Such a tumor is often found in children and adults. It not only spoils the appearance of a person, but can also negatively affect his health. Why are hemangiomas dangerous? And do I need to delete them? We will answer these questions in the article.
Description
Nasal hemangioma is a neoplasm consisting of pathologically altered vascular tissue. These tumors never degenerate into cancer, but can grow quite quickly.
Most often, hemangiomas occur in infants and the elderly. In women, such neoplasms appear more often than in men. The tumor is formed due to excessive proliferation of blood vessels, which cease to provide blood circulation at the lesion site.
Unlike other types of neoplasms, hemangiomas can disappear on their own. However, you should not fully rely on such an outcome. Spontaneous regression of the neoplasm is not always noted. A vascular tumor can not only spoil the appearance of the patient, but also adversely affect various functions of the body.
Varieties
Doctors classify these neoplasms depending on their structure. The following varieties of hemangioma of the nose are distinguished:
- Capillary. This type of tumor is formed from dilated small vessels overflowing with blood. The neoplasm is localized not deep under the skin and usually has a small size (several millimeters). Capillary hemangiomas most often appear on the tip and wings of the nose.
- Cavernous. Such a hemangioma is formed from large vessels. A tumor consists of several segments filled with blood. Hemangioma cavities communicate with each other using vascular bridges. This type of tumor is located in fatty tissue. Cavernous hemangiomas are more common in older people.
- Combined. This is a rather rare, but most severe form of hemangioma. Such a tumor consists simultaneously of small and large vessels. The upper part of the neoplasm is located under the skin, and the lower consists of several cavities and is localized in adipose tissue.
International Classification of Diseases
According to ICD-10, hemangioma refers to benign neoplasms. Such pathologies are indicated by codes D10 - D36. Tumors consisting of blood and lymph vessels are allocated in a separate group (D18). The complete hemangioma code for ICD-10 is D18.0.
Reasons for the appearance in children
Vascular tumors occur in approximately 10% of infants. They are not of a genetic nature, but are laid in the prenatal period. The cause of hemangiomas in newborns are various adverse effects on the fetus. These include:
- viral respiratory infections in a pregnant woman in the first trimester;
- eclampsia;
- hormonal disorders in the expectant mother;
- the use of drugs, alcohol, and also smoking during the gestation period.
Vascular tumors appear more often in premature babies with low weight. The risk of hemangioma in a baby increases if the age of the expectant mother is older than 37-38 years.
Causes of neoplasms in adults
Nasal hemangioma in adult patients most often occurs in old age. It is a consequence of acquired changes in the structure of blood vessels. The following factors can provoke the appearance of a tumor:
- pathologies of internal organs, accompanied by vascular disorders;
- injuries to the nose;
- frequent respiratory infections;
- allergic reactions;
- irritation of the mucous membrane of the nasal passages;
- excessive exposure to the sun;
- use of intranasal narcotic substances.
Symptomatology
If the hemangioma of the nose is located in open areas of the skin, then usually it does not affect the general well-being of a person. This neoplasm can only be determined by changes in the epidermis in the affected area. External manifestations depend on the variety and structure of the tumor.
Capillary hemangioma of the nose initially looks like a flat red spot. Over time, it grows, becomes convex and acquires a purple-purple color. The boundaries of the neoplasm are always clearly defined, and the surface is smooth. If you strongly press the tumor, its color fades significantly.
Cavernous hemangioma at the tip of the nose looks like a tuberous convex formation of blue or purple. Externally, the tumor is a bit like a grape. It can also be localized in the subcutaneous tissue of the wings and sinuses. When pressed, a dent forms. During physical exertion, a rush of blood to the hemangioma occurs, and the tumor becomes larger.
Combined hemangioma can look very diverse. The appearance of a mixed tumor depends on the predominance of capillary or cavernous elements in its structure.
Hemangiomas of the nasal cavity are much more severe than tumors located in open areas of the skin. Such neoplasms can close the lumen of the nasal passages and significantly hamper breathing. This is accompanied by the following symptoms:
- a feeling of nasal congestion;
- frequent runny nose;
- causeless nosebleeds.
In advanced cases, hearing impairment may occur. The appearance of such a symptom means that the tumor has grown in the nasopharynx and blocked the mouth of the auditory tube.
With large hemangiomas of the nasal septum, patients often experience noisy breathing and snoring during sleep. In addition, the neoplasm constantly irritates the mucous membrane. This is accompanied by a runny nose, sneezing, and a reflex cough. Amid breathing difficulties, increased fatigue and headaches due to oxygen deficiency in the body.
Danger
How dangerous are hemangiomas? As already mentioned, these tumors never undergo malignant degeneration. However, vascular neoplasms can sprout from the skin and adipose tissue to nearby tissues and organs. Such uncontrolled growth is especially characteristic for hemangiomas of the combined type.
If the tumor is localized inside the nose and its size exceeds 0.5 cm, then it greatly complicates breathing. Such a neoplasm can cause blood clots and blood poisoning.
If the hemangioma is located on the outer skin, then it is dangerous only when it grows to large sizes. The larger the tumor, the easier it is to accidentally injure it. Damage to the neoplasm is accompanied by rather profuse bleeding.
Only a specialist can assess the potential danger of hemangiomas and decide on the need to remove the tumor. Therefore, with the appearance of convex spots of red or purple color on the skin, it is necessary to visit a dermatologist.
Diagnostics
If the hemangioma is located on the outer parts of the nose, then its diagnosis is not particularly difficult. This tumor can be determined by external examination of the patient. However, in some cases, the hemangioma may resemble other neoplasms in appearance. To establish its structure, the doctor may prescribe an ultrasound diagnosis. This examination shows a capillary or cavernous tumor.
With the localization of the neoplasm inside the nasal cavity, an examination by an otolaryngologist is necessary. Radiography and angiography with a contrast agent are also prescribed. These examinations reveal changes in the soft tissues and impaired blood flow due to the appearance of hemangiomas. When doubts about the benignness of the tumor, a biopsy is prescribed.
Conservative therapy
When hemangiomas appear on the nose in a child or an adult, doctors most often recommend a dynamic observation. Indeed, in many cases, such neoplasms resolve on their own. It is necessary to periodically visit a doctor. The specialist will monitor the condition and growth of the neoplasm.
If the tumor is located on the outside of the nose, then with its growth, medication is most often used. Drug therapy is also necessary if the hemangioma is large and looks like a serious cosmetic defect.
For pharmacological treatment of hemangiomas, the drug "Propranolol" is most often used. This remedy is especially effective for capillary tumors. This medicine is available in the form of tablets and belongs to beta-blockers. It narrows blood vessels in the affected area. As a result, the hemangioma pales, its cells die, and growth stops.
Drops of "Timolol" are also used. This is a local treatment for eye diseases, but it is also used in the treatment of vascular tumors. The solution is applied directly to the affected area. It acts in the same way as Propranolol. Currently, the drug is also produced in the form of a gel under the trade name Oftan Timogel.
Another treatment option is sclerotherapy. Ethanol solution or Fibro-Wayne is injected into the tumor cavity. This helps to stop the nutrition of tumor cells. Gradually, the neoplasm completely dies. In no case should this method of treatment be used independently; this can lead to extensive tissue necrosis. Sclerosing therapy is carried out only on an outpatient basis. This is a rather painful method, so it is used mainly in the treatment of adults.
Surgical methods
In some cases, hemangioma has to be removed surgically. There are the following indications for surgery:
- tumor localization inside the nasal cavity;
- frequent bleeding;
- difficulty breathing
- increased risk of trauma to the neoplasm;
- accelerated tumor growth.
If hemangiomas are detected on the nose in newborns, dynamic observation is usually prescribed for 2 years. If the tumor during this time not only does not disappear, but also grows, then this is an indication for surgery. However, if the neoplasm interferes with normal breathing, then surgery is performed urgently.
Below you can see a photo of the child before and after removal of the hemangioma.
Hemangioma excision with a scalpel is rarely used these days. This is a rather traumatic operation, after which a noticeable scar remains on the skin. Currently, removal of the neoplasm is carried out in more gentle ways:
- Laser cauterization. This is a practically painless method. Under the influence of laser beams, the tumor resolves. After treatment, almost no residue remains on the skin. However, it is very rare to remove hemangioma in one procedure. To completely get rid of the tumor, at least 3-5 sessions are required.
- Electrocoagulation. The tumor is cauterized by high-frequency currents using a special device. This is a quick way to get rid of tumors. Usually, hemangioma can be removed in one session. However, a scar may remain on the skin after the procedure.
- Liquid nitrogen. The cauterization procedure takes only a few seconds. Under the influence of low temperatures, the cells of the hemangioma are destroyed, and the tumor disappears. A small wound remains in the affected area, which heals within 10-14 days.
The above methods allow you to radically get rid of hemangiomas. Relapse of the tumor is extremely rare. In most cases, they are associated with poorly performed removal of the neoplasm.