For many years, cytolytic agents have been used in the management of hemangiomas. One of the first was radiotherapy, an approach that some workers believe is the treatment of choice in hepatic angiomas. Furthermore, other types of hemangiomas may exhibit some degree of regression following radiotherapy. However, radiotherapy has not been found to be universally effective, and it is often used in conjunction with other types of therapy. In addition, it is potentially hazardous, particularly in the developing infant.
Chemotherapy represents another form of cytolytic therapy.
Cyclophosphamide has been used and positive results have been reported but once it was used in conjunction with other therapies it is difficult to evaluate its effectiveness. No regression of tumor masses or improvement of coagulation during cyclophosphamide therapy was recently found in two patients. Surgical removal of hemangioma has been used for hemangiomas in the gastrointestinal tract, hepatic resection and splenectomy have also been done, however when multiple or diffuse hemangiomatosis of the liver is diagnosed, radical surgery is impossible. Hepatic artery ligation or embolization have been attempted in these cases. Although the use of embolization avoids the hemorrhagic complications of surgery, inadvertent impairment of vascular supply to vital organs and tissues with secondary infarction as well as overwhelming sepsis may occur with this procedure.