A case report of combined vascular malformations with progressively growing lymphatic malformation: a potentially alarming feature of Gorham–Stout syndrome
Keywords:
Capillary- lymphatic- venous malformation, Vascular malformations, Gorham-Stout syndrome, sclerotherapyAbstract
YEESIBSEAN N*, WANANUKUL S**, PONGPRUTTHIPAN M*, BOONTAVEEYUWAT E*. A CASE REPORT OF COMBINED VASCULAR MALFORMATIONS WITH PROGRESSIVELY GROWING LYMPHATIC MALFORMATION: A POTENTIALLY ALARMING FEATURE OF GORHAM–STOUT SYNDROME. THAI J DERMATOL 2020; 36: 46-53.
*DIVISION OF DERMATOLOGY, DEPARTMENT OF MEDICINE, KING CHULALONGKORN MEMORIAL HOSPITAL AND FACULTY OF MEDICINE, CHULALONGKORN UNIVERSITY, BANGKOK, THAILAND.
**DIVISION OF DERMATOLOGY, DEPARTMENT OF PEDIATRICS, KING CHULALONGKORN MEMORIAL HOSPITAL AND FACULTY OF MEDICINE, CHULALONGKORN UNIVERSITY, BANGKOK, THAILAND.
Congenital vascular malformations are rare and potentially causing life-threatening consequences. Diagnostic as well as therapeutic approach can be very challenging, interdisciplinary team work is then required. We report a case of a young man with combined capillary-lymphatic-venous malformation (CLVM) on the right lumbar area. He presented with progressively growing, bluish compressible tissue lumps, overlaid with red plaque and small clear vesicles at the right side of lumbar area. Radiographic skeletal survey showed lumbar spine’s scoliosis. No osteolytic lesions were found. Contrast MRI revealed slow flow serpentine infiltrative vascular malformation .Combined CLVM without other anomalies was diagnosed. However, Gorham–Stout syndrome (GSD) with delayed osteolysis bone development, could be the case for our patient as progressive combined lymphatic malformation could be considered as a clinical crucial clue in clinically suspecting and diagnosing GSD later on. A long term close monitoring particularly bone pain and potentially high risk of fracture was mandatory. Minimal invasive procedure, percutaneous sclerotherapy, was arranged due to unresectable condition.
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