What is a vascular malformation?
These are disordered growths of veins and/or arteries that are present at birth and grow in proportion to the child's growth. They are not cancerous but can be painful and cause problems if they get infections, bleed, or ulcerate.
Broadly speaking, there are four main categories - capillary, arterial, venous and lymphatic malformations.
What is a capillary malformation?
These used to be called Port Wine Stains. They are disorders of the capillaries, which are the very fine blood vessels of skin. They affect approximately 1 in 1000 newborns and are three times more common in females. They most often occur on the face, in the distribution of one of the main nerves (the trigeminal nerve). This gives the effect of a dark red 'stain' over the forehead, cheek or whole side of face.
Capillary malformations / Port Wine stains do not usually cause problems, but if in the area of the eye they may rarely cause glaucoma or retinal detachment. They may also rarely affect the brain (Sturge-Weber syndrome), but again this is quite rare.
The color of the malformation can be lightened with laser treatment, although multiple sessions may be needed.
What is a Venous Malformation?
These are growths caused by disorders of the veins and are present in up to 4% of newborns. They are blue or purple in color and have a spongy texture. They usually do not cause any problems, although can occasionally extend to muscles or bone and can cause a reduction in the blood's ability to clot.
Hormone changes during puberty or pregnancy can cause enlargement of the venous malformation, leading to aching pain.
Compression stockings can help reduce the malformation when it is on an arm or leg, which may help reduce pain. Laser may help with malformations that are thin, and surgery may occasionally be used to remove the whole area. Often, though, the malformation can be treated with sclerotherapy - an agent such as pure alcohol is injected into the malformation under ultrasound guidance. More than one treatment may be needed, though, and the malformation can grow back even after treatment.
What is an Arterial malformation?
These are growths caused by disorders of the arteries. The swelling has a high flow of blood going through it, and can cause a pulsation to be felt in the area. If these ulcerate and bleed then blood loss can be considerable.
They are often treated by embolization, whereby special coils are inserted into the area under x-ray guidance. Then, within the next 72 hours, surgery is performed on the now-shrunken growth to try and remove all the abnormal area. Even so, the growth can still recur and more treatment may be required.
What is a lymphatic malformation?
Lymph is a clear fluid component of blood that bathes the tissues, bringing nutrients to the cells. The lymph then travels back into the system through special lymphatic vessels, similar to veins but smaller. A lymphatic malformation is a growth caused by disordered growth of the lymphatic vessels.
Lymphatic malformations can cause overgrowth of the underlying bone, and are prone to infections. Treatment is often by sclerotherapy, whereby an agent such as pure alcohol is injected into the area under ultrasound guidance. Laser can help treat any superficial areas on the skin, and surgery may be of benefit in certain cases.
Will I need any special tests?
Diagnosis of vascular malformations can be difficult, even for experts. X-rays, CT scans, MRI scans or ultrasound may be used to help with a diagnosis and plan treatment. Blood tests may also be needed.
Even if no treatment is planned, the specialist may want to arrange for regular follow-up appointments to monitor the growth.
The information provided is as a guide only and you should discuss matters fully with your specialist before deciding on the right procedure for you. If you have any concerns about a skin growth, seek medical advice immediately. Please also read our disclaimer