Throughout the years, various classifications have evolved for the diagnosis of vascular anomalies. However, it remains difficult to classify a number of such lesions. Because all hemangiomas were previously considered to involute, if a lesion with imaging and clinical characteristics of hemangioma does not involute, then there is no subclass in which to classify such a lesion, as reported in one of our cases. The recent classification proposed by the International Society for the Study of Vascular Anomalies (ISSVA, 2014) has solved this problem by including non-involuting and partially involuting hemangioma in the classification. We present here five cases of vascular anomalies and discuss their diagnosis in accordance with the ISSVA (2014) classification. A non-involuting lesion should not always be diagnosed as a vascular malformation. A non-involuting lesion can be either a hemangioma or a vascular malformation depending upon its clinicopathologic and imaging characteristics.
Classification ; Diagnosis* ; Head* ; Hemangioma ; Neck* ; Vascular Malformations

PURPOSE: We evaluated the clinical, plain radiographic, and anglographic findings of congenital vascular malformation of the soft tissue. METHODS AND MATERIALS: Retrospective analysis was performed in 36 patients. Pathological diagnosis was done in 25 patients by surgery and the others were clinically and anglographically diagnosed. On the basis of anglographic findings, we classified the lesions to three groups as arteriovenous malformation(AVM), hemangioma, and venous malformation. In pathologically proven 25 cases, we compared the anglographic diagnosis with the pathologic diagnosis. RESULTS: By anglographic classification, AVM was 13 cases, hemangioma 16 cases, and venous malformation 7 cases. The locations of the lesions were upper extremities in 14 cases, lower extremities in 20 cases, both extremities in 1 case, and back in 1 case. Clinical findings were bruit and thrill in 13 cases(12 AVMs, 1 hemangioma) and varicosities in 16 cases(11 AVMs, 3 hemangiomas and 2 venous malformations). The varicosities in AVM were pulsating nature, but not in hemangioma and venous realformation. The concordance rate of the anglographic and pathologic diagnosis was 100%(6/6) in AVM, 71%(10/14) in hemangioma and 60% (3/5) in venous malformation. CONCLUSION: We think that angiography is an essential study for accurate diagnosis and appropriate treatment of congenital vascular malformation.
Angiography ; Classification ; Diagnosis ; Extremities ; Hemangioma ; Humans ; Lower Extremity ; Retrospective Studies ; Upper Extremity ; Vascular Malformations*

Vascular lesions of the oral and maxillofacial area is interesting to clinicians because it is difficult in management and has poor prognosis. There have been attempt to classify vascular lesion and recently new classification is introduced that have two basic entities, 1) hemangioma, 2) vascular malformation. It is useful that evaluation of lesion, treatment planning and predicting on prognosis. But vascular lesion is still difficult to clinicians about treatment. A case of acinic cell carcinoma combined with hypervascularity arising on the hard palate in a 28-year-old woman is reported. We mistook it for vascular lesion because of hypervascularity. The clinical and histologic feature are described. Literatures about neovascularization of tumor & acinic cell carcinoma are reviewd, too. And we attempt to solve the problem of hypervascularity.]]>
Acinar Cells ; Adult ; Carcinoma, Acinar Cell ; Classification ; Female ; Hemangioma ; Humans ; Palate, Hard ; Prognosis ; Vascular Malformations

Face ; blood supply ; Hemangioma ; classification ; diagnosis ; therapy ; Humans ; Jaw ; blood supply ; Lymphatic Abnormalities ; classification ; diagnosis ; therapy ; Mouth ; blood supply ; Vascular Malformations ; classification ; diagnosis ; therapy

OBJECTIVETo summarize clinical and pathological characteristics and surgical experiences of venous malformations in parotid region.

METHODS39 cases of venous malformations in parotid region were divided into peripheral, honeycomb-like and reticular three classifications according to clinical manifestations and histological characters. Surgical treatments were correspondingly selected as overall excision, overall excision and superficial lob of parotid excision after facial nerve dissection, overall excision and superficial lob of parotid excision combined with pingyangmycin injection.

RESULTS26 cases were cured, 9 cases with excellent result and 4 cases with effective result.

CONCLUSIONSThe new effective classification of venous malformations in parotid region can be a guide to the selection of the therapy on them.

Adolescent ; Adult ; Child ; Hemangioma, Cavernous ; classification ; surgery ; Humans ; Male ; Parotid Neoplasms ; classification ; surgery ; Parotid Region ; blood supply ; Vascular Malformations ; classification ; surgery ; Young Adult

BACKGROUND: Hemangiomas of infancy are common, benign, pediatric tumors of endothelial cells. This is characterized by an initial phase of rapid proliferation, which is followed by slow involution, often leading to complete regression. There has been no large clinicopathological study in Korea. OBJECTIVE: The purpose of this study was to investigate the clinicopathological findings of hemangioma of infancy in Korean patients. METHODS: The clinical study included 256 patients of hemangioma of infancy. Histopathological examination of 18 cases was done with H&E staining. We also performed immunohistochemical staining with GLUT1 in 10 cases. RESULTS: The study results are summarized as follows: 1. The male to female ratio was 1: 3.1. Half of the lesions were noticed at birth. 2. The sites of predilection were head and neck (68.9%), upper extremities (11.7%), trunk (10.2%), and lower extremities (8.8%). 3. The results of clinical classification by depth of lesion were: superficial hemangioma (63.7%), deep hemangioma (20.9%), and combined hemangioma (15.4%). 4. The results of histopathological classification by the developmental phase were: proliferating phase (16.7%), involuting phase (83.3%). 5. In the immunohistochemical study using GLUT1, three out of ten cases of hemangioma were stained positively. CONCLUSION: The clinical findings of our study were identical with previous published reports. The characteristic expression of GLUT1 in hemangioma of infancy can be helpful in differentiating them from other vascular tumors and vascular malformations, and in the examination of developmental pathogenesis in hemangioma.
Classification ; Endothelial Cells ; Female ; Head ; Hemangioma* ; Humans ; Korea ; Lower Extremity ; Male ; Neck ; Parturition ; Upper Extremity ; Vascular Malformations

Congenital vascular malformations (CVM) have many different clinical presentations, ranging from an asymptomatic birthmark to a life-threatening status. There has been confusion in the classification of these malformations. Two major classification systems are used at the present time: one is the Mulliken and coworkers' system that has been adopted by the International Society for the Study of Vascular Anomalies, and the other is the Hamburg classification that was declared in the 7th Meeting of the International Workshop on Vascular Malformations in Hamburg 1988. The latter is used in this article. BACKGROUND: There are many difficulties in the surgical extirpation of CVM because of their invasiveness, variability, hypervascularity, and evolutibility, especially in a diffuse infiltrating type of CVM. Thus, many endovascular ablative agents have been utilized since 1930s, but there were some handicaps, such as recanalization of previously treated vessels. Since the 1980s, Yakes has reported on much research about the effectiveness of absolute alcohol (98% ethyl alcohol) which incurs permanent vessel wall destruction. AIMS: We performed this study to evaluate the effectiveness of pure ethanol (95-99% ethyl alcohol, Samsung Medical Center, Seoul, Korea) in the treatment of inoperable CVM, to identify the complications that occur and to establish the method of endovascular ablative therapy. MATERIALS AND METHODS: From August 1996 through October 1997, we applied 37 sessions of sclerotherapy using direct puncture technique with pure ethanol to 19 patients with the extratruncular, diffuse infiltrating type of CVM (11 predominantly venous, 8 predominantly arteriovenous shunting)among 250 CVM patients registered at the CVM Clinic of Vascular Center at Samsung Medical Center. RESULTS: Angiographically, the results were excellent in 33 (89%) and good in 3 (9%) sessions. Only one (3%) session failed due to extravasation of the contrast media. The mean follow-up period was only 6 months; 17 (89%) patients were symptomatically improved. Some complications, such as ischemic bullae, deep vein thrombosis, and hematuria, developed, but those patients were recovered without any problem. CONCLUSIONS: The short-term results of pure ethanol sclerotherapy for the diffuse infiltrating type of CVM were good. With more clinical experience, this new treatment modality will be more effective. Further investigations are needed to solve the some complications.
Classification ; Contrast Media ; Education ; Ethanol* ; Follow-Up Studies ; Hematuria ; Humans ; Punctures ; Sclerotherapy* ; Seoul ; Vascular Malformations* ; Venous Thrombosis

We can classify the vasular anomalies into hemangiomas and vascular malformations in accordance with Mulliken's classification. But most surgeons and physicians have not yet been used to these terminologies and so incoherent terms have frequently caused problematic confusion in the interdepartment discussion, many trial and errors and uncontrollable patients' distrust with the waste of time in spite of various kinds of therapeutic practices. It is primarily important that the selection of therapeutic methods must be decided, assuming the usage of an accurate diagnosis and academic terms. The differntial diagnosis between hemangiomas and superficial vascular malfomations (capillary or venous malformations) is especially bewared and then the surgical resection is always considered as a method of treatment modalities, especially at any time whenever other practices end in failure or ineffective. Sometimes, patient's descriptions and clinical features of lesions during follow up periods are more helpful in the diagnosis of lesions than other studies especially in long-term or recurred, complicated vascular lesions. In primay venous malformations, we have tried surgical resections and in recurred cases radical resection and immediate reconstruction with normally vascularized flap have been applied. Such normally vascularized island and free flaps can prevent the postoperative ischemic bed from stimulating the dormant or inactivated shunts and causing new pathologic potentials of recurrence. Over a 2-year period, 16 patients underwent surgery. Of the 16 patients, 8 superficial vascular anomalies had previous malpractices such as inappropriate laser therapy or steroid. They had all surgical resection and reconstructive procedure if needed. The another 8 patients of venous malformations involving the face, neck and hand had radical resection and reconstruction with a normally vascularized island or free flap for prevention of recurrence. The mean follow-up period was 11 months and no recurrence was observed.
Classification ; Diagnosis ; Follow-Up Studies ; Free Tissue Flaps ; Hand ; Hemangioma ; Humans ; Laser Therapy ; Neck ; Recurrence ; Vascular Malformations

PURPOSE: To assess the embolization effect of dural arteriovenous fistula(DAVF). MATERIALS AND METHODS: Weevaluated 23 patients with DAVF who were diagnosed using digital subtraction angiography and treated bytransarterial and/or transvenous emobolization. The locations of DAVFs, as seen on angiography were as follows: 16in the cavernous sinus, four in the major dural sinuses, two in the jugular bulb, one in the torcula Herophili,and one in the tentorium cerebelli. On the basis of venous drainage patterns, Cognard's classification of DAVF wasused. Among our 23 patients, 13 underwent transarterial embolization, six underwent transvenous embolization, andfour underwent both. After embolization, three patients underwent other treatment: surgery, one ; gammairradiation, one ; and both. One. Polyvinyl alcohol particles or glue was used in transarterial embolization, andtungsten, platinum, or Guglielmi detachable coils in transvenous embolization. To analyse the residual lesion inDAF, we compared pre- and post-treatment angiograms ; patients were followed up for 2 to 48 months, and theircondition was assessed as cured, improved, not changed, or aggravated. RESULTS: Nine patients were found to beCognard type I, two were IIa, four were IIa+b, and eight were type III. Of our 23 patients, 12 were cured, tenimproved, and one was aggravated ; of the 13 who underwent transarterial embolization, four were cured, eightimproved, and one was aggravated ; of the six who underwent transvenous embolization, five were cured and oneimproved. The condition of a patient with a lesion in the torcular herophili was aggravated despite surgery andgamma irradiation after embolization. CONCLUSION: DAVF can be managed successfully with endovascular treatment.The outcome of the transvenous approach appears to be better than that of the transarterial approach alone. In acase involving a lesion in the torcular herophili, the outcome was poor and more aggressive treatment wasrequired.
Adhesives ; Angiography ; Angiography, Digital Subtraction ; Arteriovenous Fistula ; Cavernous Sinus ; Central Nervous System Vascular Malformations* ; Classification ; Drainage ; Humans ; Platinum ; Polyvinyl Alcohol

PURPOSE: We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). MATERIALS AND METHODS: From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. RESULTS: The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. CONCLUSION: Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.
Adolescent ; Adult ; Aorta, Thoracic/*abnormalities ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Intestines/*abnormalities/*blood supply ; Lung/*abnormalities/*blood supply ; Male ; Vascular Malformations/*classification