Cavernous hemangioma

A type of blood vessel malformation

Ultrasound of hemangioma in the liver.

Cavernous hemangioma
Synonyms	Cavernoma, cavernous angioma, cavernous vascular malformation
Pronounce
Field	Dermatology, Neurology, Hepatology, Radiology
Symptoms	Often asymptomatic; when symptomatic, may cause headache, seizures (in brain), abdominal pain (in liver), or visible skin lesions
Complications	Hemorrhage (especially in the brain), neurological deficits, seizures, compression of surrounding tissue
Onset	Congenital (present at birth), symptoms may appear later in life
Duration	Lifelong
Types	Cerebral cavernous malformation, hepatic cavernous hemangioma, cutaneous hemangioma
Causes	Congenital malformation of blood vessels; may be sporadic or inherited (autosomal dominant pattern in familial cases)
Risks	Family history (for familial cerebral cavernous malformation), female sex (for hepatic hemangiomas)
Diagnosis	MRI, CT scan, Ultrasound, biopsy (rarely required)
Differential diagnosis	Arteriovenous malformation, venous angioma, tumors, cysts, metastases (in liver)
Prevention	None
Treatment	Observation (if asymptomatic), surgical excision, stereotactic radiosurgery (brain lesions), embolization (rare)
Medication	Anticonvulsants (for seizures), pain management
Prognosis	Generally good with appropriate management; risk of bleeding in cerebral cases
Frequency	Common; hepatic hemangiomas are the most common benign liver tumors; cerebral cavernomas affect ~0.5% of the population
Deaths	Rare, primarily due to hemorrhage in brain lesions

Small hemangioma on the scalp of a two-year-old female.

A simplified overview of mammalian MAPK pathways

A cavernous hemangioma, also known as a cavernoma, is a type of vascular malformation characterized by a cluster of dilated blood vessels. These lesions can occur in various parts of the body, including the brain, liver, and skin. They are typically benign but can cause significant clinical symptoms depending on their location and size.

Pathophysiology

Cavernous hemangiomas are composed of large, blood-filled vascular spaces separated by thin walls of connective tissue. Unlike capillary hemangiomas, which are composed of small capillaries, cavernous hemangiomas have larger, cavern-like spaces. These lesions are often congenital and can be associated with genetic conditions such as cerebral cavernous malformations (CCM), which are linked to mutations in the CCM1, CCM2, or CCM3 genes.

Clinical Presentation

The symptoms of a cavernous hemangioma depend on its location:

• Brain: When located in the brain, cavernous hemangiomas can cause seizures, headaches, and neurological deficits. They may also lead to intracerebral hemorrhage if they bleed.
• Liver: In the liver, these lesions are often asymptomatic and discovered incidentally during imaging studies. However, large hemangiomas can cause abdominal pain or hepatomegaly.
• Skin: Cutaneous cavernous hemangiomas appear as soft, bluish nodules and are usually asymptomatic but can be cosmetically concerning.

Diagnosis

Diagnosis of cavernous hemangiomas typically involves imaging studies. Magnetic resonance imaging (MRI) is the preferred method for detecting brain cavernomas, as it provides detailed images of the vascular structures. Computed tomography (CT) scans and ultrasound can be used to identify hemangiomas in the liver and other organs.

Treatment

The management of cavernous hemangiomas depends on their location and symptoms:

• Observation: Asymptomatic lesions, especially in the liver, are often monitored with regular imaging studies.
• Surgical Resection: Symptomatic brain cavernomas may require surgical removal, particularly if they cause seizures or significant bleeding.
• Stereotactic Radiosurgery: This non-invasive procedure can be used for brain cavernomas that are difficult to access surgically.

Prognosis

The prognosis for individuals with cavernous hemangiomas varies. Many people with these lesions live normal lives without symptoms. However, those with symptomatic brain cavernomas may experience recurrent seizures or neurological issues. Regular follow-up and monitoring are essential for managing potential complications.

Related Pages

• Vascular malformation
• Cerebral cavernous malformation
• Hemangioma
• Intracerebral hemorrhage

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