Hemangiomas: Should Treatment Be Expectant Or Active?

Abstract

For the last five years several cases of vascular tumors (mainly infantile strawberry and cavernous hemangiomas) which had vanished without therapy were observed and the literature on the subject perused. It is difficult to form an exact idea of the percentage of such occurrences because of the prevailing opinion, especially among radiologists and surgeons, that it is unwise or dangerous to leave hemangiomas untreated. There is also parental unwillingness to wait for three or four years for spontaneous involution. Consequently, the great majority of such patients receive treatment in one form or another. To repeat Traub’s words of nineteen years ago, “the obvious confusion existing in the minds of most physicians in regard to the proper disposition of vascular nevi” is still with us. I do not advocate expectant therapy for all cases; however, being convinced that a large majority do involute spontaneously, I am in favor of no therapy in selected cases in which the lesions are located in covered body areas or may easily be removed surgically at a later date in the event spontaneous involution does not materialize.