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Vascular Tumor
David Sudarto Oeiria,MD, FAAD, FAADV
Chairman, Dep. of Dermato-‐Venereology
School of medicine, Wijaya Kusuma University
Indonesia
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Vascular Anomalies
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Vascular anomalies are common birthmarks
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1.Vascular malformaIons: error of
morphogenesis
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2.Hemangioma and other vascular tumors:
cellular proliferaIon
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NATURAL HISTORY OF HEMANGIOMAS AND VASCULAR MALFORMATIONS
0 0.5
Progression
~5 (varies) Age (years)
Vascular malformations
Proliferating hemangioma
Involuting hemangioma
Involuted hemangioma
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InfanIl hemangioma
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Most common hemangioma
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Female is more than male, raIo 2:1
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More in premature infant and mulIple
gestaIon pregnancy
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Not full developed when birth, but start to
grow soon aQer, the proliferaIve phase follow
by slower involuIon phase
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Mixed Hemangioma
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Pathophysiology
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Hemangioma cells are immature and
imcomplete differenIated
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Rapid growth for the first few months follow
proliferaIng phase
2 years old involuIng
phase, apoptosis almost
max
4 years old, some further
involuIon
Most of IH completed their course at 7-‐10 years
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Skin aQer involuIon
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Superficial IH: normal skin
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Atropic, Some scar, fibroadipose degeneraIon
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Residual teleangiectasia
E
subcutaneous
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Mandibular segmental IH( beard distribuIon) with laryngeal
hemangioma (airway hemangioma)
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ComplicaIon
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UlceraIon
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Block the vision
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Block the airway
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Medical IntervenIon
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CorIcosteroid
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Propanolol
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Pulsed dye laser for superficial IH
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Surgical intervenIon
Angioblastoma of Nakagawa
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RARE
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Pyogenic granuloma
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Vascular malformaIon, PWS baby,
surface halus, lesi akan persistent
C
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PWS pada dewasa
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Jaringan dibawah tumor juga bisa
overgrowth
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Infant of portwine stain at risk of
Sturge Weber Syndrome
V1, V2 and V3
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PWS of the body
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Sturge-‐Weber Syndrome
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Sturge-‐Weber syndrome (SWS), also called
encephalotrigeminal angiomatosis, is a
neurocutaneous disorder with angiomas that
involve the leptomeninges (leptomeningeal
angiomas [LAs]) and the skin of the face,
typically in the ophthalmic (V1) and maxillary
(V2) distribuIons of the trigeminal nerve
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Risk of Sturge-‐Weber Syndrome
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LymphaIc malformaIon
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Dorman AVM
Dorman AVM
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Expanding type
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