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AMA Arch Surg. 1954;68(4):538-545. doi:10.1001/archsurg.1954.01260050540018.
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HEMANGIOMAS, sometimes called vascular nevi, are common. Though congenital in origin, many of them are not noticed by family physician, obstetrician, pediatrician, or family until the third to fifth postnatal week. They may then be interpreted as birth injury and their importance minimized. However, pathologic implications become distinct as growth occurs, particularly in cavernous tumors which bulge when the child cries or strains. Tumors may be single or multiple, deep or superficial, small or large, usually superficial and exposed. Many and various therapeutic measures have been tried, and residual "tracks" of destructive treatment include hypertrophied scars, keloid, pits, dermatoses, blanched spots, atrophic or maldeveloped tissues, ulcers, and epitheliomas. Surgery is often ignored as a possibility for primary treatment, though in many cases it would provide the most decisive approach and would leave minimum residual defect. It is logical to suggest that surgery should be used first, not last, in cases


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