eMedicine Specialties > Plastic Surgery > Skin

Vascular, Lymphatic Malformations: Follow-up

Author: Meir Cohen, MD, MPS, Consulting Staff, Department of Plastic Surgery, Schneider Children's Medical Center of Israel, Tel Aviv University
Coauthor(s): Shimon Maimon, MD, Head of Invasive Radiology Unit, Beilinson Campus, Rabin Medical Center, Israel; Dan Ben-Amitai, MD, Head of Pediatric Dermatology Service, Lecturer, Schneider Children's Medical Center of Israel; Eric Bensimon, MD, Clinical Instructor, Department of Surgery, University of Montreal
Contributor Information and Disclosures

Updated: Feb 5, 2008

Outcome and Prognosis

Lymphatic lesions gradually enlarge and worsen with time.3 Surgery is the only complete cure for this problem. However, this is not always possible, and the goal of treatment in many patients is improvement rather than cure.

Future and Controversies

A significant contribution to the understanding of vascular lesions is the introduction of a classification method by Mulliken and associates.2 This made diagnosis and treatment more accurate and predictable. However, confusing and occasionally misleading terms used by different subspecialties are still found.

Improvement in patient monitoring and anesthesia during and after surgery made early excisions and transcutaneous sclerosis safer and more acceptable.

A major controversy is the timing of operative procedures. No clear-cut answer exists to this question. The authors believe that decisions should be made according to the individual patient. The psychosocial consequences of growing up with a facial deformity always should be taken into consideration.

Future research of specific genes and their angiogenic growth factor products will contribute to the understanding of the mechanism underlying the formation of lymphatic VMs and may provide new modalities of treatment at the gene level.5

 


More on Vascular, Lymphatic Malformations

Overview: Vascular, Lymphatic Malformations
Workup: Vascular, Lymphatic Malformations
Treatment: Vascular, Lymphatic Malformations
Follow-up: Vascular, Lymphatic Malformations
Multimedia: Vascular, Lymphatic Malformations
References
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References

  1. Patrice SJ, Wiss K, Mulliken JB. Pyogenic granuloma (lobular capillary hemangioma): a clinicopathologic study of 178 cases. Pediatr Dermatol. Dec 1991;8(4):267-76. [Medline].

  2. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. Mar 1982;69(3):412-22. [Medline].

  3. Mulliken JB. Vascular anomalies. In: Aston SJ, Beasley RW, Thorne CHM, eds. Grabb and Smith Plastic Surgery. 5th ed. NY: Lippincott Raven Publishers; 1997.

  4. Jackson IT, Carreño R, Potparic Z, Hussain K. Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment. Plast Reconstr Surg. Jun 1993;91(7):1216-30. [Medline].

  5. Breugem CC, van Der Horst CM, Hennekam RC. Progress toward understanding vascular malformations. Plast Reconstr Surg. May 2001;107(6):1509-23. [Medline].

  6. Carmeliet P, Collen D. Vascular development and disorders: molecular analysis and pathogenic insights. Kidney Int. Jun 1998;53(6):1519-49. [Medline].

  7. Alomari AI, Karian VE, Lord DJ, Padua HM, Burrows PE. Percutaneous sclerotherapy for lymphatic malformations: a retrospective analysis of patient-evaluated improvement. J Vasc Interv Radiol. Oct 2006;17(10):1639-48. [Medline].

  8. Suzuki Y, Obana A, Gohto Y, Miki T, Otuka H, Inoue Y. Management of orbital lymphangioma using intralesional injection of OK-432. Br J Ophthalmol. Jun 2000;84(6):614-7. [Medline].

  9. Padwa BL, Hayward PG, Ferraro NF, Mulliken JB. Cervicofacial lymphatic malformation: clinical course, surgical intervention, and pathogenesis of skeletal hypertrophy. Plast Reconstr Surg. May 1995;95(6):951-60. [Medline].

  10. Armstrong DC, ter Brugge K. Selected interventional procedures for pediatric head and neck vascular lesions. Neuroimaging Clin N Am. Feb 2000;10(1):271-92, x. [Medline].

  11. Marler JJ, Mulliken JB. Current management of hemangiomas and vascular malformations. Clin Plast Surg. Jan 2005;32(1):99-116, ix. [Medline].

  12. Buckmiller LM, Richter GT, Waner M, Suen JY. Use of recombinant factor VIIa during excision of vascular anomalies. Laryngoscope. Apr 2007;117(4):604-9. [Medline].

  13. Zuker MR, Cohen M. Congenital hand anomalies (discussion). In: Goldwyn RM, Cohen MN, eds. The Unfavorable Result in Plastic Surgery Avoidance and Treatment. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2000:710-713.

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Further Reading

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Keywords

VM, vascular lesion, lymphangioma, cystic hygroma, hemangioma, lymphatic malformation, lymph malformation, congenital skin lesion, acquired skin lesion, congenital vascular lesion, acquired vascular lesion, skin malformation, vascular malformation

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Contributor Information and Disclosures

Author

Meir Cohen, MD, MPS, Consulting Staff, Department of Plastic Surgery, Schneider Children's Medical Center of Israel, Tel Aviv University
Meir Cohen, MD, MPS is a member of the following medical societies: American Cleft Palate/Craniofacial Association and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Coauthor(s)

Shimon Maimon, MD, Head of Invasive Radiology Unit, Beilinson Campus, Rabin Medical Center, Israel
Disclosure: Nothing to disclose.

Dan Ben-Amitai, MD, Head of Pediatric Dermatology Service, Lecturer, Schneider Children's Medical Center of Israel
Dan Ben-Amitai, MD is a member of the following medical societies: Israel Medical Association
Disclosure: Nothing to disclose.

Eric Bensimon, MD, Clinical Instructor, Department of Surgery, University of Montreal
Eric Bensimon, MD is a member of the following medical societies: American Society of Plastic Surgeons, Canadian Society of Plastic Surgeons, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Shahin Javaheri, MD, Chief, Department of Plastic Surgery, Martinez Veterans Affairs Outpatient Clinic; Consulting Staff, Advanced Aesthetic Plastic & Reconstructive Surgery
Shahin Javaheri, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Wayne Stadelmann, MD, Stadelmann Plastic Surgery, PC
Wayne Stadelmann, MD is a member of the following medical societies: Alpha Omega Alpha, New Hampshire Medical Society, Northeastern Society of Plastic Surgeons, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

 
 
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