Surgical treatment of hemangiomas and arteriovenous malformations in upper extermity
Languages of publication
Hemangiomas belong to one of the most common type of tumors occurring in childhood. They are benign and often do not require any treatment, with the tendency to. frequently disappearing spontaneously at the age of 5-7 years. The tumors usually develop in the head and neck area, whereas vascular malformations (AVMs) are rare congenital anomalies, which may occur anywhere. In upper limb, they may amount to 30-60% of cases. It is common for these changes not to require any surgical treatment. In case they do, the main indications for such treatment of upper limb AVMs may be as follows: signs of compression of the peripheral nerves, limited mobility of the fingers because of the tumor, which entails difficulties in the functioning of the whole arm, pain and aesthetic considerations.Aim of the study was to present the results of surgical treatment of vascular tumors (hemangiomas and AVMs) in the upper limb that was applied in our department, as well as a broader discussion on epidemiology, diagnosis, and treatment of these changes.Material and methods. In 2003-2011 period we treated 11 patients aged 24-39, suffering from vascular tumors (hemangiomas / vascular malformations) in the upper limb; the group included 3 men and 8 women. In this group we diagnosed 2 cases with arm hemangiomas, 2 cases of intramuscular hemangiomas of the forearm, 2 cases of hemangiomas in metacarpal area, 2 cases of AVMs of the finger and metacarpal area, and 4 cases of isolated vascular malformations (mainly arteriovenous malformations) of the fingers. All preparations were examined histologically.Results. No complications or recurrence were found in 7 cases, recurrences of AVMs were observed in 4 patients with finger changes. In one patient with AVMs of the index finger, we observed a treble recurrence, which severely impaired functioning of his hand. We eventually suggested to him the finger amputation, to which the patient agreedConclusions. Upper extremity is a rare location of hemangiomas and other vascular malformations requiring surgery. hemangiomas are more common in women, and the occurrence of AVMs in both males and females is similar. Surgical treatment of hemangiomas and AVMs of the upper extremities is doubtlessly an arduous task, which calls for great microsurgical skills.
1 - 03 - 2013
20 - 04 - 2013
- 1. Nandaprasad S, Sharada P, Vidya M et al.: Hemangioma - A Review, The Internet Journal ofHematology ISSN: 2009; 1540-2649.
- 2. Mulliken JB, Głowacki J: Classification of pediatric vascular lesions. Plast Reconstr Surg 1982; 70(1): 120-21.[PubMed]
- 3. Beck DO, Gosain AK : The presentation and management of hemangiomas, Plast Reconstr Surg 2 0 0 9 ; 1 2 3 ( 6 ) : 1 8 1 e - 9 1 e . d o i : 1 0 . 1 0 9 7 / PRS.0b013e3181a65c59.
- 4. Cahill AM , Nijs EL : Pediatric vascular malformations: pathophysiology, diagnosis, and the role of interventional radiology. Cardiovasc InterventRadiol 2011; 34(4): 691-704. doi: 10.1007/s00270-011-0123-0. Epub 2011 Mar; 16.[Crossref]
- 5. Thawait SK , Puttgen K, Carrino JA et al.: MR imaging characteristics of soft tissue vascular anomalies in children. Eur J Pediatr 2012; 18.[WoS]
- 6. Gampper TJ, Morgan RF : Vascular anomalies: hemangiomas. Plast Reconstr Surg 2002; 110(2): 572-85; quiz 586; discussion 587-88.[Crossref]
- 7. Van Aalst JA, Bhuller A, Sadove AM : Pediatric vascular lesions. J Craniofac Surg 2003; 14(4): 566-83.
- 8. Jackson IT , Carreño R, Potparic Z: Hemangiomas, vascular malformations, and lympho-venous malformations: classification and methods of treatment. Plast Reconstr Surg 1993; 91(7): 1216-30.[Crossref]
- 9. Mallan E, Pulgionisi A: Congenital angiodysplasias of the extremities. i. generalities and classification; venous dysplasias. J CardiovascSurg (Torino). 1964; 5: 87-130. No abstract available.
- 10. Malan E, Puglionisi A: Congenital angiodysplasias of the extremities. II. Arterial, arterial and venous, and haemolymphatic dysplasias. J CardiovascSurg (Torino). 1965; 6(4): 255-345. No abstract available.
- 11. Park UJ, Do YS , Park KB et al.: Treatment of arteriovenous malformations involving the hand. Ann Vasc Surg 2012; 26(5): 643-8. doi: 10.1016/j. avsg.2011.08.016. Epub 2012 Jan; 23.[PubMed][Crossref]
- 12. Balakrishnan G.: Vascular anomalies of the upper limb. Indian J Plast Surg 2011; 44(2): 276-82. doi: 10.4103/0970-0358.85349.[PubMed][Crossref]
- 13. Koman LA : Diagnostic study of vascular lesions. Hand Clin 1985; 1(2): 217-31. Review.
Publication order reference