These lesions grow slowly and steadily throughout life and do not spontaneously regress. There are several types of vascular malformations: venular (port wine), venous, lymphatic, arteriovenous and mixed malformations. The diagnosis for the vascular malformation will depend on the vessel affected.
Venous Malformations is an abnormality of the larger, deep vessels and often appears very similar to a deep hemangioma. VM is the most common type of vascular malformation. A VM is always present at birth but are not always evident. They may first become noticeable in childhood or even adulthood. Most VM appear in the skin. Venous Malformations are commonly found in the cheek, tongue, lip and jaw. They may be present in deep tissue, bone, muscle or any other organ. They are found in the liver, gastrointestinal tract and spleen. There is an incidence in the brain of about 0.5%.
Venous Malformations appear dark blue and are most often very soft. They grow over the life of the individual. Unlike a hemangioma a VM will not experience the prolific growth phase and they never spontaneously regress/involute. Serious illness, trauma, infection and hormone changes of puberty and pregnancy are associated with growth of the lesions.
A VM will grow over the life of the individual, however; sometimes there is a sudden enlargement noted. This is often due to a clot within the vessels of the VM. Injury, Pregnancy, Puberty or in women taking birth control may result in an enlargement of the VM. The enlargement can result in symptoms of pain. Clot formation in a VM is serious and should be evaluated by a physician.
A VM can be treated by a procedure known as sclerotherapy. Scelerotherapy is done by injecting a small amount of a solution to the vessels. The solution irritates the lining of the vessel and causes the vessel to close off due to inflammation. Sclerotherapy may be done alone or combined with surgery. Only small VM can be treated successfully with laser. Only an experienced interventional radiologist should perform scelerotherapy of a VM.
Arteriovenous Malformations (AVM): An AVM is formed when there are abnormal connections between the arterial and venous side of circulation. Abnormal blood flow is associated with these lesions. AVM is present at birth. As the lesion ages, the vessels enlarge and thicken to compensate for the increased blood supply. The exact cause is unknown. It is believed that the abnormality occurs early in fetal development. (5-6 week gestationally). There are two major types of AVM. Low Grade AVM and High Grade AVM. This is determined by blood flow through the malformation. Because flood flow can be shunted away from the normal flow patterns, treatment is often necessary. An AVM may feel like a firm mass under the skin and does not compress easily. Commons sites are the lips, head and neck areas but they may be found anywhere. There are many complications associated with AVM and all individual suspected of a AVM should be evaluated by a vascular anomaly team.
Lymphatic Malformations:commonly called cystic -hygroma, hemangiolymphangioma, or lymphangiomas. The lymphatic system is a collection and transfer. system for fluid in the body’s tissue. Abnormally developed lymphatic channels result in excess fluid accumulation in both the tissue and the vessels themselves. When the vessels involved are close to the surface of the skin there will be a prominent enlargement of the area. If the face is involved the face will swell and become disfigured. If it occurs in the mouth or tongue it can interfere with eating and breathing. (lesions in the tongue are often describe as appearing as small papules or frog eggs) They may enlarge following an upper respiratory infection. These lesions may occur anywhere but are most common in the head and neck. Lymphatic Malformations increase or grow with the patient. They are difficult to treat.
The information on this page is not to be used for medical diagnosis or treatement. This is for informational purposes only and has been gathered from several sources including www.novanews.org/information/vascular-malformations.
