Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

Congenital Hemangiomas

While the cause of hemangiomas remains unknown and many children start exhibiting signs of a hemangioma after birth, some hemangiomas start to develop and become fully grown while the fetus is still in the womb. There are two types of congenital, or inborn, hemangiomas: rapidly involuting congenital hemangiomas (RICH) and non­-involuting congenital hemangiomas (NICH). These tumors are solitary and are most commonly found on the head, limbs, or near the groin.

Rapidly Involuting Congenital Hemangiomas (RICH)

RICH is a type of vascular tumor that grows in the womb. It is present at birth, then starts to rapidly regress. The hemangioma starts to recede and disappears completely by the age of 14 months.

Even though RICH disappears on its own, some patients will experience complications such as:

  • Atrophy of the skin where hemangioma was located
  • Telangiectasia, characterized by spider veins near the surface of the skin where the hemangioma was located

Further treatments, including plastic surgery, may be needed to repair the skin in order to achieve an acceptable cosmetic result.

Non­-Involuting Congenital Hemangiomas (NICH)

NICH is a type of vascular tumor that also arises in the womb and is present at birth. But unlike RICH, non­-involuting congenital hemangiomas do not regress; instead they continue to grow as the child grows. These types of vascular tumors cause significant disfigurement of the involved tissues, and often require treatment with a combination of sclerotherapy and surgery.

In some cases, patients can exhibit both features of RICH and NICH, a condition called a partially involuting congenital hemangioma (PICH).

At New York Eye and Ear Infirmary, our vascular birthmark specialists will develop a customized treatment plan to address each case for maximum medical and cosmetic results.

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