AI Article Synopsis
- The study aims to enhance treatment for extremity low-flow vascular malformations by examining histology and imaging of venous malformations (VMs) that didn’t improve after sclerotherapy.
- Out of 102 patients treated with sclerotherapy, 19 underwent surgery due to inadequate response, with a notable prevalence of angiomatosis of soft tissue (AST) among lower-extremity intramuscular lesions.
- The findings highlight the importance of histological analysis in distinguishing between AST and VMs, as they can appear similar on imaging, which is crucial for effective treatment decisions.
Article Abstract
Background We aimed to improve management of extremity low-flow vascular malformations by analyzing the histology and imaging of venous malformations (VMs) not responsive to sclerotherapy. Method We reviewed patient records of 102 consecutive patients treated with sclerotherapy for extremity VM in our institution to identify patients who had undergone surgery due to insufficient response. We semi-quantitatively analysed the tissue specimens and compared histological findings to those in preoperative imaging. Result The number of patients operated on was 19 (18.6%); 15 of them had lower-extremity intramuscular lesions. The histological pattern of 13 of these 15 lesions corresponded to angiomatosis of soft tissue (AST). All other lesions treated surgically were VMs. The histology of AST was distinctive but magnetic resonance imaging findings often overlapped with those of VM. Conclusion AST is easily mixed with intramuscular VM. The differentiation of these two entities has therapeutic importance. We emphasize the role of histology in the differential diagnostics of intramuscular slow-flow vascular malformations.
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