Venous Malformations Workup

  • Author: Silvio Podda, MD; Chief Editor: Gregory Caputy, MD, PhD, FICS   more...
 
Updated: Nov 21, 2011
 

Laboratory Studies

  • Typically, no laboratory tests are indicated for cutaneous venous malformations. Clotting studies and CBC may be indicated in an occasional visceral lesion that is bleeding. If a particular anomaly is a diagnostic dilemma, urinary bFGF rarely may be indicated as part of the workup.
  • A 2005 study was able to differentiate between proliferating hemangiomas and vascular malformations based on serum vascular endothelial growth factor (VEGF) levels.[1]
  • Perform a coagulation profile on children with extensive disease, as there is a risk for low-grade, localized intravascular coagulopathy (LIC). Disseminated intravascular coagulopathy (DIC) is rare.
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Imaging Studies

  • Plain radiographs - Phleboliths pathognomonic
  • MRI
    • Most informative modality
    • Hyperintense on T2-weighted images
    • No flow voids
    • Inhomogeneous contrast enhancement (like CT)
  • CT scan
    • Inhomogeneous contrast enhancement (like MRI)
    • Phleboliths easily seen
  • Ultrasound - Hypoechogenic, septated mass
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Diagnostic Procedures

  • Arteriography has little or no role in venous malformation unless the diagnosis is unclear.
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Histologic Findings

  • If the diagnosis is in doubt, biopsy the lesion!
  • Most venous malformations are diagnosed based on a good history and physical examination; all of the above studies are ancillary.
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Silvio Podda, MD  Craniofacial and Plastic Surgeon, Department of Plastic and Reconstructive Surgery, St Joseph's Regional Medical Center and Children's Hospital

Silvio Podda, MD is a member of the following medical societies: American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, and Northeastern Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Frederick J Duffy, Jr, MD, FACS  Clinical Assistant Professor, Department of Plastic Surgery, University of Texas Southwestern Medical School

Frederick J Duffy, Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reconstructive Microsurgery, American Society of Plastic Surgeons, Plastic Surgery Research Council, and Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jorge I de la Torre, MD, FACS  Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; 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.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Gregory Caputy, MD, PhD, FICS  Chief Surgeon, Aesthetica Plastic and Laser Surgery Center, Inc

Gregory Caputy, MD, PhD, FICS is a member of the following medical societies: American Society for Laser Medicine and Surgery, Canadian Medical Association, International College of Surgeons, International College of Surgeons US Section, Pan-Pacific Surgical Association, and Wound Healing Society

Disclosure: Syneron Corporation Salary Speaking and teaching

References

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