Hemangioma is a congenital benign tumor or vascular malformation, mostly seen in infants at birth or shortly after birth, it originates from the residual embryonic angiogenic cells, active endothelial germ invades into the adjacent tissues, forming endothelial-like cords, and then forms hemangiomas after tubularization and connecting with the blood vessels left behind, the blood vessels in the tumor form a self-contained system and are not connected with the peripheral blood vessels. Hemangiomas occurring in the oral and maxillofacial region account for 60% of the hemangiomas in the whole body, and most of them occur in the facial skin, subcutaneous tissues, and oral mucosa, such as the tongue, lips, the floor of the mouth and other tissues, and a few of them occur in the jawbone or deep tissues. Traditional classification of hemangiomas According to the structure, hemangiomas are divided into several categories: capillary hemangiomas, cavernous hemangiomas, mixed and trapezoidal hemangiomas. Congenital hemangiomas are also classified as hemangiomas and vascular malformations according to the biological characteristics of vascular endothelial cells. The two have obvious differences in clinical manifestations and biological characteristics. Clinically, strawberry capillary hemangioma, the majority of cavernous hemangioma and mixed hemangioma belong to hemangioma; while wine stains and trapezoidal hemangioma and a very small portion of cavernous hemangioma belong to vascular malformation. Etiology During human embryonic development, especially in the early stage of vascular tissue differentiation, due to the small-scale misconfiguration of its controlling gene segments, which leads to abnormal tissue differentiation in specific parts of the human embryo and develops into hemangiomas. In the early embryonic stage (8 to 12 months), the embryonic tissues suffer from mechanical injury and local tissue hemorrhage resulting in the distribution of some hematopoietic stem cells to other embryonic characteristic cells, some of which differentiate into vascular-like tissues and eventually form hemangiomas. Clinical manifestations 1. Capillary hemangioma is composed of a large number of intertwined and dilated capillaries. It is characterized by bright red or purple-red plaques. It is flush with the skin surface or slightly elevated, with clear boundary, irregular shape and different sizes. When the tumor is pressed by finger, the color recedes; after the pressure is lifted, the color is restored. 2.Cavernous hemangioma consists of enlarged blood vessel cavity and blood sinus lined with endothelial cells. The blood sinus is of different sizes, like a spongy structure, and the sinus cavity is filled with venous blood and traffic with each other. It appears as a soft, slow-growing mass with no conscious symptoms. When the head is in a low position, the tumor expands due to blood congestion, and the mass returns to its original shape after returning to the normal position. In superficial tumors, the surface skin or mucous membrane is greenish purple. In the deep part, the skin color is normal. On palpation, the mass is soft, with unclear boundary and no pressure pain. When squeezed, the mass shrinks and returns to its original size after the pressure is lifted. Trapezoidal hemangioma is mainly formed by the anastomosis of dilated artery and vein. The tumor is high up in the form of rosary or earthworm. There are sensation of movement and tremor when looking at it, and there is wind-like murmur on auscultation. If the blood-supplying artery is completely compressed, the above motility and murmur disappear. General laboratory tests show no specific findings. For superficial and limited tumors, the examination protocol is based on limit “A”; for deeper sites or large tumors, the examination protocol may include limit “B” and “A”. A”. Cervical radiographs are valuable for understanding the size and extent of deep tumors or whether the tumor has invaded the cervical spine or laryngeal cartilage. If preoperative angiography is done to know the trophic branches of the hemangioma, ligation of the supplying vessels at both ends of the hemangioma can reduce intraoperative bleeding and facilitate total resection of the hemangioma. Diagnosis According to clinical manifestations, general diagnosis of neck hemangioma is not difficult, but special attention should be paid if it violates some important organs in the deep neck, such as carotid artery and larynx. Puncture of the tumor is very helpful for diagnosis, and if blood is drawn out, the diagnosis can be confirmed. Treatment There are many treatment methods for hemangioma, which should depend on the type, location, depth of the tumor and the age of the patient. Commonly used methods include: surgical excision, radiation therapy, cryosurgery, sclerotherapy and laser irradiation.