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Infantile hemangioma

Synonyms: Blutschwamm, Säuglingshämangiom

By Dr. Pascal Bafteh · last updated 09/2026

Infantile hemangioma: Flat, bright red vascular lesion on an infant's forearm. — Gstk, „Infantile hemangioma, flat", CC BY-SA 4.0, via Wikimedia Commons · CC BY-SA 4.0 · Source

Infantile hemangioma: Gesicht — M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara, „Hemangioma 01", CC BY 2.0, via Wikimedia Commons · CC BY 2.0 · Source

Overview: ISSVA Classification 2018

Tumors: Infantile hemangioma (IH), congenital hemangiomas (RICH/PICH/NICH), pyogenic granuloma, angiosarcoma — Characteristic: proliferative, GLUT1±, mitotically active
Malformations: Nevus flammeus / Port-Wine Stain, AVM, venous / lymphatic / combined — Characteristic: NO proliferation, grows with patient, no spontaneous regression

Infantile Capillary Hemangioma (IH)

Epidemiology & Pathogenesis

Incidence: 4–5% of all infants, premature infants up to 30%, sex F: M = 4: 1.
Pathogenesis: The cause is angiogenesis defect (VEGF, placental hypoxia) — IH endothelial cells express GLUT1 + (together with placental endothelia), indicating placental embolization or stem cell differentiation.
Course: 3-phase — proliferative 0–9 months (fastest growth 5–8 weeks) → plateau 9–12 months → involution 1st–7th year of life at ~10%/year; spontaneous regression in ~50% by 5th year of life (~70% by 7th year of life), residual changes (fibrofatty tissue, telangiectasias, atrophic skin) in 25–50%.

Diagnostics

Clinical + Ultrasound / Doppler (hypervascular lobular architecture), for deep involvement MRI with contrast medium.
GLUT1 immunohistochemistry: for clinically unclear findings — GLUT1+ = IH; GLUT1− (negative) = congenital hemangioma (RICH/PICH/NICH) or malformation.

Complications

Periorificial: Strabismus / amblyopia due to globe compression in eyelid IH (immediate ophthalmological referral!), stridor / dyspnea in subglottic IH.
General: Ulceration (10–15%, pain!), secondary infection, bleeding, scarring residual changes.

Associated Syndromes

PHACES: Acronym = Post. Fossa + Hemangioma + Arterial + Cardiac + Eye + Sternal — MRI skull + echo + ophthalmological evaluation obligatory.
PELVIS / SACRAL / LUMBAR: segmental ulcerated lumbosacral hemangiomas + urogenital + spinal malformations → MRI spine + pelvis obligatory.
Disseminated Hemangiomatosis: ≥ 5 cutaneous hemangiomas → Ultrasound screening liver / GI tract for visceral hemangiomas.

Differential diagnoses

Haemangioma
Pyogenic granuloma
Cutaneous angiosarcoma
Kaposi's sarcoma
Port-wine stain
Non-involuting congenital hemangioma (NICH)

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Sources (selection)

Krowchuk 2019 IH Guidelines

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Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.