Hemangioma - Blood Sponge - Stork Bite

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Hemangioma - Blood Sponge - Stork Bite
Hemangioma - Blood Sponge - Stork Bite
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Hemangioma (blood sponge)

Infantile hemangioma (IH) - also known as “stork bite” or “blood sponge” - is the most common benign tumor in childhood. It usually begins as a small red spot in the first two weeks of life. In contrast, the rare so-called congenital hemangioma is already fully developed at birth. Hemangiomas usually only occur singly and only develop in children, never in adulthood.


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  • Hemangioma: what forms are there?
  • Appearance
  • What complications can arise?
  • How is the diagnosis made?
  • How is a hemangioma treated?
  • Whom can I ask?
  • How are the costs covered?

Hemangiomas are the most common benign tumors in young children. They occur in ten to twelve percent of all infants, girls are three to five times more likely to be affected than boys. Performing a chorionic villus sampling during pregnancy doubles the risk of IH. The causes are still largely unknown. There is currently no way to prevent the development of a hemangioma.

Hemangiomas often occur in the head and neck area, mostly within the skin. However, they can also develop in internal organs such as the liver, lungs, digestive tract and brain.

Hemangioma: what forms are there?

A distinction is made between the frequently occurring infantile hemangioma (HI) and the rare so-called congenital, i.e. congenital, hemangioma.

Infantile hemangioma

This vascular tumor consists mainly of endothelial cells that line the walls of all blood vessels. A so-called biphasic growth pattern is typical: first the tumor grows (proliferation phase), then it shrinks again (involution phase).

Proliferation phase: At the beginning there is usually a rapid growth that tends to decrease over time.

Involution phase: After about six to twelve months, the IH stops growing on its own and slowly begins to shrink again. At around six to eight years of age, the final stage of the "Involved Infantile Hemangioma" is reached. About half of it disappears completely, leaving no visible skin changes. The other half leaves subtle skin defects such as atrophic (thin) skin, small dilated blood vessels and slight discoloration. An involved hemangioma will never grow again.

Congenital hemangiomas

Congenital hemangiomas are already fully developed in the uterus or at the time of birth. A distinction is made between two types:

  • Never Involuting Congenital Hemangioma (NICH): They show neither growth nor shrinkage, but instead retain their size.
  • Rapidly Involuting Congenital Hemangioma (RICH): They start to shrink immediately after birth. This rapid involution can be completed between the 12th and 14th month of life.


The appearance of a hemangioma is influenced by a wide variety of factors, e.g. its location (superficial or rather deep) and its current phase.

Infantile hemangiomas show a typical appearance during the proliferation phase:

  • Superficial hemangiomas are usually bright red, raised, lobed tumors.
  • Deep hemangiomas are usually recognizable from the outside as raised, bluish-livid swellings.
  • Mixed hemangiomas show both parts. Veins draining from the tumor can be visible in either type.

During the involution phase, the hemangioma gradually becomes paler and smaller.

Congenital hemangioma is grayish in color - possibly surrounded by a pale ring - with protruding veins.

What complications can arise?

Complications occur in around ten percent of those affected - these are also known as high-risk hemangiomas. These include:

  • Ulcers (ulcers),
  • Pain,
  • Very rapidly growing or very large hemangioma
  • Distortion of facial features due to the size or location of the hemangioma,
  • Impairment of a physical function due to the size or location of the hemangioma (including movement of an extremity, hindrance to breathing, seeing or hearing)
  • Multiple visible hemangiomas: These suggest the possibility that internal organs could also be affected.

About one percent of children develop life-threatening complications.

How is the diagnosis made?

Most hemangiomas are detected by a physical examination of the child in conjunction with the medical history. To confirm the diagnosis, to determine the spread of the tumor and to rule out other diseases (especially vascular malformations, malignant tumors), further examinations may be useful, e.g.

  • Ultrasonic,
  • Roentgen,
  • Magnetic resonance imaging (MRI),
  • Computed Tomography (CT) or
  • Biopsy.

How is a hemangioma treated?

In most children, hemangiomas go away on their own. Therefore, no treatment is usually necessary. If changes such as loose skin, color deviations or small, dilated blood vessels remain, these can be improved surgically and / or cosmetically using laser therapy - preferably before school starts to avoid stigmatizing the affected child.

In the case of so-called high-risk hemangiomas, intervention is necessary - either to prevent significant cosmetic impairment or to ensure vital functions (e.g. breathing, sight or hearing). Selective beta blockers are particularly suitable as drug treatment. They lead to a rapid constriction of the affected vessels. As a result, the discoloration becomes paler and the structures soften.

Surgical measures are recommended for some hemangiomas (eg, eyelid tumors or hemangiomas constricting the airways). Laser therapy can only be used to a limited extent due to the insufficient depth of penetration.

Whom can I ask?

Treatment is not necessary for small hemangiomas that shrink on their own. However, regular check-ups should be carried out by a pediatrician.

If the diagnosis is unclear or a high-risk hemangioma is present, the child should be referred to a specialist in vascular abnormalities.

If you have cosmetic problems, you should consult a specialist in aesthetic surgery. Interdisciplinary cooperation between different specialists may be recommended.

How are the costs covered?

All necessary and appropriate diagnostic and therapeutic procedures are taken over by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

If a hospital stay is required, the hospital costs will be invoiced. The patient has to pay a contribution to the costs per day.

For more information, see What does a hospital stay cost?

Note Purely cosmetic treatments are to be paid for by the patient themselves.

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