Hemangioma

My daughter was born with a Hemangioma just below her lowest right rib. She is now 3 1/2 and it has grown to sort of an oval shape approx. 6cm x 10cm. It is raised about 3/4 inch above the surface and a large mass can be felt underneath. It has stopped growing but has not yet started to fade.  We did have an ultrasound to make sure it was not attached to any major organs and all was OK.  Our goal is to leave her with the least noticable scar possible.  We can't find any information on Hemangiomas  at this location of the body (most are located on the face/head).  I would like to know what this will look like if we have nothing done and let it regress itself (will it cave in)?  Would you recommend undergoing laser surgery, excision or something else? Is it better to wait till she is older?  Till now we have just dealt with the Family Dr., Should we see someone else?  Sometimes I feel selfish for wanting this taken care of but children are cruel and I would like to help my daughter feel as normal as possible.  Any advice or recommendations would be welcome.
Thank You!

[Alan Rockoff, MD]

Most likely, you are describing a strawberry hemangioma.  These start at or soon after birth, enlarge for a while, and most regress by age 9.  When they go away, they may leave a scar.  Laser treatment can help them go away faster, and is safe, though a bit painful.  I would consult a dermatologist who works with the pulsed dye laser.  Any teaching hospital with a dermatology department would be a good place to start for a consultation.  Insurance will most likely not cover the procedure, which may take several sessions and cost anywhere from a few hundred to a thousand dollars or more.  It's not out of the question to ask, but you may decide to hold off until she's a bit older.  3 year olds are too big to hold down and too small to reason with.  Also, the final cosrmetic outcome is less crucial than if it were on the face.

Best.

Dr. Rockoff