Vascular Anomalies: Recognition

Objective

• By the end of the presentation the participants will be able to recognize vascular lesions on clinical appearance.

ISSVA 2014• The International Society for the Study of Vascular

Anomalies was founded in 1992 during the International Workshop on Vascular Anomalies held in 1990 in Amsterdam.

• The term anomalies encompasses hemangiomas and vascular malformations. The purpose of the Society is to promote, on a national and international level, clinical and scientific research in all fields, that will lead to advances in knowledge concerning all aspects of vascular anomalies.

Vascular anomaliesVascular Tumors Vascular malformations

Infantilehemangioma

Congenitalhemangioma

NICH RICH

• Capillary malformation • Venous malformation• Lymphatic malformation

• Arterial malformation • Arteriovenous fistula• Arteriovenous malformation

Combined types

Slow flow Fast flow

Differentiating Features

TUMOR• True tumors, with

proliferation of the vascular endothelium

• >3:1 female : male• Small or absent at birth• Rapid growth during infancy • Self-limited• Diagnosis: Clinical +

appearence

MALFORMATION• No tumor, comprised of

dysplastic vessels• 1:1 female : male• Present at birth• Growth proportional to child• Never disappear• Diagnosis: MRI, Doppler

ultrasonography, angiography

RICH

NICH

Infantile Hemangioma

Tufted hemangioma

Spindle cell hemangioma

Pyogenic granuloma

Kaposiform hemangioendothelioma

Retiform hemangioendothelioma

Papillary intralymphaticangioendothelioma

Composite hemangioendothelioma

Kaposi sarcoma

Angiosarcoma

Capillary Malformations

CM with bone or soft tissue overgrowth

Sturge Weber Syndrome

Hereditary hemorrhagic telengiectasia

Nevus simplex

27

Lymphatic Malformations

In the oral cavity appear as multiple translucent non-compressible cysts or vesicles of <2 cm.

containing viscous clear fluid, producing apebbly or warty surface resembling “frogspawn” or “tapioca pudding”.

MICROCYSTIC LM ( Outdated term Lymphangioma)

Macro Cystic LM

Gorham Stout disease

Primary Lymphedema

Common Venous Malformation

Familial cutaneomucosal vascular malformation

Blue rubber bleb nevus syndrome

Glomuvenous malforation

Sporadic AVM

AVM in HHT

Arterio venous fistula

Conclusion

• Vascular tumors are to be differentiated from vascular anomalies.

• The distinction is possible by history and careful clinical examination most of the time.

• In doubtful cases, biopsy is required.

Thank you

• QUESTIONS?• Or test will follow…