Life-threatening hemorrhage from a vulvar hemangioma

Bava, G. L.; Dalmonte, Pietro; Oddone, M.; Rossi, Umberto

doi:10.1053/jpsu.2002.31645

Cited by 21 publications

(16 citation statements)

References 5 publications

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“…This complication occurs in approximately 12% of patients and resolves with early drug discontinuation [2]. Angiographic embolization may also be used for nonresponsive complicated lesions [13]. Surgical excision of IHs of the female external genitalia is rarely necessary and is typically reserved for ulcerative and painful lesions refractory to medical management.…”

Section: Discussionmentioning

confidence: 99%

Vascular anomalies of the female external genitalia

Vogel

Alesbury

Burrows

et al. 2006

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Vascular anomalies of the female external genitalia

Vogel

Alesbury

Burrows

et al. 2006

Journal of Pediatric Surgery

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“…Large arterio-venous malformations can be treated by embolisation, where it can be an alternative to, or a preparation for operation 10. Selective embolisation sometimes has to be carried out through two or more steps to avoid or reduce risks of complications, primarily acute ischaemia caused by occlusion of important anomalous arteries 10. Besides our case, we found two other case reports showing good results after embolisation of vulvar arterio-venous malformation by using a coil 11 12…”

Section: Discussionmentioning

confidence: 67%

“…In a minority of patients, the situation and rapidly increasing size may cause life-threatening complications, functional problems or cosmetic damage 7 10. All complicated vascular malformations require treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Sclerotherapy is indicated in case of small and not diffuse venous malformations 3. Large arterio-venous malformations can be treated by embolisation, where it can be an alternative to, or a preparation for operation 10. Selective embolisation sometimes has to be carried out through two or more steps to avoid or reduce risks of complications, primarily acute ischaemia caused by occlusion of important anomalous arteries 10.…”

Section: Discussionmentioning

confidence: 99%

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Coiling of a vulvar arterio-venous malformation

Woude

Stegeman²,

Seelen³

2011

Case Reports

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SummaryThe authors report the case of a 13-year-old girl with a painful vulvar swelling and abnormal vaginal bleeding, increasing in size after trauma. With MRI (GE Signa HDx 1.5 Tesla), it is diagnosed as an arterio-venous malformation arising from the left superior femoral artery. It is treated by embolisation using a coil. benign soft-tissue tumours characterised by rapid postnatal growth followed by slow, invariable, spontaneous regression during childhood. 2 Vascular malformations are developmental errors which do not regress, and are composed of dysmorphic vessels with normal endothelial turnover. 2 3 The latter is subcategorised into arterial, venous (formerly 'cavernous haemangioma'), capillary, lymphatic or mixed types. 1 4 Vascular malformations can also be differentiated at the haemodynamic level between low-fl ow malformations, that include capillary and venous malformations, and high-fl ow malformations that include arterial malformations, arterio-venous fi stula and arterio-venous malformations. 1-2 5 The diagnosis of vascular malformations can be strongly suspected by careful history and physical examination. Venous malformations present as bluish, easily compressible non-pulsatile masses that increase in size with manoeuvres to increase venous pressure (Valsalva manoeuvre). 3 6 In case of vascular high fl ow malformations, pulsations are present. 7 Clinical symptoms include vulvar dysmenorrhoea, sexual dysfunction, swelling, pressure, discomfort, pain, abnormal vaginal bleeding and cosmetic problems. 2-3 8 Vascular malformations may be complicated by cutaneous ulceration and haemorrhage, limb hypertrophy or even high-output cardiac failure. 7 Venous malformations should be distinguished from vulvar varicosities ( table 1 ). 3 Vulvar varicosities are typical complications of pregnancy resulting from pelvic venous hypertension and they appear as a grapelike cluster of veins on the vulva. 3 6 While vulvar varicosities result from venous insuffi ciency or stasis, vascular malformations of the vulva are developmental errors, composed of dysmorphic vessels, and they do not regress. 6 Vascular malformations may undergo a rapid increase in size as a result of infection, thrombosis, trauma, surgical intervention and hormonal changes (as during puberty or in pregnancy). 2 5 7 For cases with progressive lesions in older women, a pathologic opinion is always necessary to rule out underlying malignancies. Regarding this point, biopsy may be indicated for superfi cial, localised and small lesions when clinical and imaging presentation is atypical. 2 Other differential diagnostic thoughts, besides varicosities and vulvar malignancies are outlined in table 2 . 2 Diagnosis of vascular malformations is primarily clinical and is confi rmed by ultrasound, colour Doppler ultrasound and MRI. 2 3 6-7 Ultrasounds reveal hypoechoic, heterogeneous lesions and yields reliable and adequate information regarding the nature and extend of a superfi cial malformation. 2-3 6 Colour Doppler analysis illustrates mono-or biphasi...

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“…7 Embolization and surgical excision are reserved for the most refractory cases. 7,10 Psychosocial Support. This is critical for parents and families of patients with ulcerated HOI, or any HOI for that matter, as well as for children as they become aware of the hemagioma.…”

Section: Complicationsmentioning

confidence: 99%

What's Your Diagnosis? A 3-Month-Old Girl with An Ulcerated Perineal Plaque

Trager

2005

Journal of Pediatric and Adolescent Gynecology

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Life-threatening hemorrhage from a vulvar hemangioma

Cited by 21 publications

References 5 publications

Vascular anomalies of the female external genitalia

Vascular anomalies of the female external genitalia

Coiling of a vulvar arterio-venous malformation

What's Your Diagnosis? A 3-Month-Old Girl with An Ulcerated Perineal Plaque

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