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Case#2
History: A male child with an upper lip soft
vascular malformation, not pulsatile or painful.
Imaging Studies:
-
Photo (1st image)
-
MRI - T2 weighted image (2nd image): bright lesion, sharp
margins, consistent with VM
- MRI- Post
contrast image (3rd image): Intense contrast
enhancement, consistent with VM
- CTA (4th
image) - A vascular lesion with a good size
draining vein into the facial vein (arterial
involvement unclear)
- Arteriogram
-arterial phase (5th image): Tiny arterial
feeders are seen from the facial artery
- Arteriogram
- venous phase (last image): Several
draining veins are seen.
Diagnosis:
Capillary Venous Malformation. Although this
malformation was initially considered a venous malformation based on history, clinical
presentation and MRI, arteriography showed that
the malformation has multiple tiny feeding
arteries with multiple draining veins resulting
in relatively rapid arteriovenous shunt (similar
to AVMs). The final diagnosis was capillary
venous malformation (CVM). Treatment:
This lesion was embolized two times with poor
response. The lesion was subsequently removed
surgically.
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