AJP Rep 2015; 05(01): e37-e42
DOI: 10.1055/s-0034-1544107
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Extensive Fetal Congenital Subcutaneous Mixed Venous Lymphatic Lesion: Prenatal Diagnosis and Postnatal Management

I. N. Odibo
1   Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Arkansas
,
L. E. Linam
2   Department of Radiology, Arkansas Children's Hospital, Arkansas
,
G. E. Richter
3   Department of Otolaryngology, Arkansas Children's Hospital, Arkansas
,
R. J. Jackson
3   Department of Otolaryngology, Arkansas Children's Hospital, Arkansas
,
N. K. Dajani
1   Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Arkansas
› Author Affiliations
Further Information

Publication History

24 July 2014

04 December 2014

Publication Date:
25 February 2015 (online)

Abstract

Vascular lesions may be categorized as proliferative tumors, such as hemangiomas, or nonproliferative malformations that include capillary, lymphatic, venous, arterial, or mixed lesions. Lymphatic malformations are benign localized congenital malformations of the lymphatic system. They may be microcystic or macrocystic lesions or a combination of both. The lesions may also be uniseptate or multiseptate, and are more commonly located in the head and neck or axillary region. Prenatal diagnosis is based on ultrasound and magnetic resonance imaging. Postnatal management largely depends on the size and location of the lesion. This is the first case report of prenatally diagnosed extensive subcutaneous macrocystic venous lymphatic malformation involving the fetal thorax, back, pelvis, and lower extremities. Prenatal course and postnatal management are described. This report will aid other specialists in the field of prenatal diagnosis and postnatal surgery in the evaluation and management of these patients.

 
  • References

  • 1 Mulliken JB, Young A. Vascular Birthmarks: Hemangiomas and Malformations. Philadelphia, PA: WB Saunders; 1988
  • 2 Burrows PE, Mason KP. Percutaneous treatment of low flow vascular malformations. J Vasc Interv Radiol 2004; 15 (5) 431-445
  • 3 Sherer DM, Perenyi AR, Glick SA , et al. Prenatal sonographic findings of extensive low-flow mixed lymphatic and venous malformations. J Ultrasound Med 2006; 25 (11) 1469-1473
  • 4 Fonkalsrud EW. Congenital malformations of the lymphatic system. Semin Pediatr Surg 1994; 3 (2) 62-69
  • 5 Suzuki N, Tsuchida Y, Takahashi A , et al. Prenatally diagnosed cystic lymphangioma in infants. J Pediatr Surg 1998; 33 (11) 1599-1604
  • 6 Marler JJ, Fishman SJ, Upton J , et al. Prenatal diagnosis of vascular anomalies. J Pediatr Surg 2002; 37 (3) 318-326
  • 7 Kaminopetros P, Jauniaux E, Kane P, Weston M, Nicolaides KH, Campbell DJ. Prenatal diagnosis of an extensive fetal lymphangioma using ultrasonography, magnetic resonance imaging and cytology. Br J Radiol 1997; 70 (835) 750-753
  • 8 Ruano R, Aubry JP, Simon I , et al. Prenatal diagnosis of a large axillary cystic lymphangioma by three-dimensional ultrasonography and magnetic resonance imaging. J Ultrasound Med 2003; 22 (4) 419-423
  • 9 Yang JI, Kim HS, Ryu HS. Prenatal sonographic diagnosis of Klippel-Trenaunay-Weber syndrome: a case report. J Reprod Med 2005; 50 (4) 291-294
  • 10 Chen CP, Lin SP, Chang TY , et al. Prenatal sonographic findings of Klippel-Trénaunay-Weber syndrome. J Clin Ultrasound 2007; 35 (7) 409-412
  • 11 Richards DS, Williams CA, Cruz AC, Hendrickson JE. Prenatal sonographic findings in a fetus with Proteus syndrome. J Ultrasound Med 1991; 10 (1) 47-50
  • 12 Nahm WK, Moise S, Eichenfield LF , et al. Venous malformations in blue rubber bleb nevus syndrome: variable onset of presentation. J Am Acad Dermatol 2004; 50 (5, Suppl): S101-S106
  • 13 Puig S, Casati B, Staudenherz A, Paya K. Vascular low-flow malformations in children: current concepts for classification, diagnosis and therapy. Eur J Radiol 2005; 53 (1) 35-45
  • 14 Sapp JC, Turner JT, van de Kamp JM, van Dijk FS, Lowry RB, Biesecker LG. Newly delineated syndrome of congenital lipomatous overgrowth, vascular malformations, and epidermal nevi (CLOVE syndrome) in seven patients. Am J Med Genet A 2007; 143A (24) 2944-2958
  • 15 Alomari AI. Characterization of a distinct syndrome that associates complex truncal overgrowth, vascular, and acral anomalies: a descriptive study of 18 cases of CLOVES syndrome. Clin Dysmorphol 2009; 18 (1) 1-7
  • 16 Clove syndrome community; Available at: http://www.clovessyndrome.org/index.cfm . Accessed on September 23, 2013
  • 17 Mulliken JB. Vascular anomalies. In: Aston SJ, Beasley RW, Thorne CHM, , eds. Grabb and Smith Plastic Surgery. 5th ed. NY: Lippincott Raven Publishers; 1997
  • 18 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 2006; 17 (10) 1639-1648
  • 19 Deshpande P, Twining P, O'Neill D. Prenatal diagnosis of fetal abdominal lymphangioma by ultrasonography. Ultrasound Obstet Gynecol 2001; 17 (5) 445-448
  • 20 Watari H, Yamada H, Fujino T , et al. A case of intrauterine medical treatment for cystic hygroma. Eur J Obstet Gynecol Reprod Biol 1996; 70 (2) 201-203
  • 21 Lei ZM, Huang XX, Sun ZJ, Zhang WF, Zhao YF. Surgery of lymphatic malformations in oral and cervicofacial regions in children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104 (3) 338-344
  • 22 Ricciardelli EJ, Richardson MA. Cervicofacial cystic hygroma. Patterns of recurrence and management of the difficult case. Arch Otolaryngol Head Neck Surg 1991; 117 (5) 546-553
  • 23 Padwa BL, Hayward PG, Ferraro NF, Mulliken JB. Cervicofacial lymphatic malformation: clinical course, surgical intervention, and pathogenesis of skeletal hypertrophy. Plast Reconstr Surg 1995; 95 (6) 951-960
  • 24 Churchill P, Otal D, Pemberton J, Ali A, Flageole H, Walton JM. Sclerotherapy for lymphatic malformations in children: a scoping review. J Pediatr Surg 2011; 46 (5) 912-922