Head and Neck ImagingHaemangioma, head and neck
vascular tumour that enlarges by rapid cellular
proliferation. It is the most common
tumour of childhood. Haemangiomas are not usually seen at birth, but show a rapid postnatal
proliferation with slow involution afterwards. A
haemangioma should not be confused with a
vascular malformation, which is present at birth (although not always evidently) and grows with the child into adulthood. (See,
vascular malformation head and neck.)
About 60% of haemangiomas occur in the head and neck. Most are cutaneous lesions, but they also occur in the deeper tissues. Haemangiomas are fairly frequently seen in the parotid gland. They may block the airway when located within the nose or larynx (Fig.1). Laryngeal haemangiomas typically occur in the subglottic region, most often in the posterior area. Such a subglottic haemangioma may be potentially life-threatening (Fig.2). The diagnosis is made by CT or MRI: haemangiomas usually appear as well circumscribed masses with homogeneous enhancement after contrast administration; they may show a more variegated enhancement pattern in their involuting phase.
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Axial contrast-enhanced CT image at level of subglottis. Three-month old child with obstructive breathing, necessitating tracheostomy. A haemangioma (arrow) obliterates the subglottic airway. Right lobe of thyroid gland (t), common carotid artery (arrowhead), internal jugular vein (v).
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Haemangioma, head and neck, Fig.1 | | Haemangioma, head and neck, Fig.2 | |