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Lymphatic Vascular Malformations of the Limbs: Treatment of Extratruncular Malformations

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Hemangiomas and Vascular Malformations

Abstract

The development of the Hamburg classification, along with a better understanding of congenital vascular malformations (CVMs), has allowed a more concise description of the lymphatic malformation (LM). The management of LM has become clear: “lymphangioma” should no longer be considered a single LM lesion but rather one of two different LM lesions belonging to an extratruncular lesion, even though the management of lymphangioma is different from its “truncular” LM lesion counterpart that clinically presents as primary lymphedema. Although they often present as discrete clinical entities, the lesions can occur together, making clinical management confusing.

Treatment options for extratruncular lymphangioma should be approached cautiously, as for any other extratruncular CVM lesion, when options such as sclerotherapy and/or surgical excision are being considered.

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References

  1. Bastide G, Lefebvre D (1989) Anatomy and organogenesis and vascular malformations. In: Belov S, Loose DA, Weber J (eds) Vascular malformations. Einhorn-Presse Verlag GmbH, Reinbek, pp 20–22

    Google Scholar 

  2. Woolard HH (1922) The development of the principal arterial stems in the forelimb of the pig. Contrib Embryol 14:139–154

    Google Scholar 

  3. Leu HJ (1990) Pathomorphology of vascular malformations: analysis of 310 cases. Int Angiol 9:147–155

    Article  CAS  PubMed  Google Scholar 

  4. Belov S (1989) Classification, terminology, and nosology of congenital vascular defects. In: Belov S, Loose DA, Weber J (eds) Vascular malformations. Einhorn-Presse, Reinbek, pp 25–30

    Google Scholar 

  5. Lee BB, Laredo J, Lee TS, Huh S, Neville R (2007) Terminology and classification of congenital vascular malformations. Phlebology 22(6):249–252

    Article  CAS  PubMed  Google Scholar 

  6. Lee BB, Baumgartner I, Berlien HP, Bianchini G, Burrows P et al (2013) Consensus Document of the International Union of Angiology (IUA)-2013. Current concept on the management of arterio-venous management. Int Angiol 32(1):9–36

    CAS  PubMed  Google Scholar 

  7. Lee BB, Kim YW, Seo JM et al (2005) Current concepts in lymphatic malformation (LM). Vasc Endovascular Surg 39(1):67–81

    Article  CAS  PubMed  Google Scholar 

  8. Lee BB, Villavicencio L (2010) Chapter 68. General considerations. Congenital vascular malformations. Section 9. Arteriovenous anomalies. In: Cronenwett JL, Johnston KW (eds) Rutherford’s vascular surgery, 7th edn. Saunders Elsevier, Philadelphia, pp 1046–1064

    Google Scholar 

  9. Lee BB, Villavicencio JL (2010) Primary lymphedema and lymphatic malformation: are they the two sides of the same coin? Eur J Vasc Endovasc Surg 39:646–653

    Article  CAS  PubMed  Google Scholar 

  10. Lee BB (2005) Lymphedema-angiodysplasia syndrome: a prodigal form of lymphatic malformation (LM). Phlebolymphology 47:324–332

    Google Scholar 

  11. Lee BB, Andrade M, Bergan J, Boccardo F, Campisi C et al (2010) Diagnosis and treatment of primary lymphedema – consensus document of the International Union of Phlebology (IUP)-2009. Int Angiol 29(5):454–470

    CAS  PubMed  Google Scholar 

  12. Gloviczki P, Duncan A, Kalra M, Oderich G, Ricotta J et al (2009) Vascular malformations: an update. Perspect Vasc Surg Endovasc Ther 21(2):133–148

    Article  PubMed  Google Scholar 

  13. Alqahtani A, Nguyen LT, Flageole H et al (1999) 25 years’ experience with lymphangiomas in children. J Pediatr Surg 34(7):1164–1168

    Article  CAS  PubMed  Google Scholar 

  14. Orvidas LJ, Kasperbauer JL (2000) Pediatric lymphangiomas of the head and neck. Ann Otol Rhinol Laryngol 109(4):411–421

    Article  CAS  PubMed  Google Scholar 

  15. Mitsukawa N, Satoh K (2012) New treatment for cystic lymphangiomas of the face and neck: cyst wall rupture and cyst aspiration combined with sclerotherapy. J Craniofac Surg 23(4):1117–1119

    Article  PubMed  Google Scholar 

  16. Lee BB, Laredo J, Neville R (2011) Primary lymphedema as a truncular lymphatic malformation. In: Lee B, Bergan J, Rockson SG (eds) Lymphedema: a concise compendium of theory and practice, 1st edn. Springer, London, pp 419–426

    Chapter  Google Scholar 

  17. Lee BB, Laredo J, Neville R, Mattassi R (2011) Primary lymphedema and Klippel-Trenaunay syndrome. In: Lee BB, Bergan J, Rockson SG (eds) Lymphedema: a concise compendium of theory and practice, 1st edn. Springer, London, pp 427–436

    Chapter  Google Scholar 

  18. Lee BB (2005) Current issue in management of chronic lymphedema: personal reflection on an experience with 1065 patients. Lymphology 38:28–31

    CAS  PubMed  Google Scholar 

  19. Lee BB (2004) Critical issues on the management of congenital vascular malformation. Ann Vasc Surg 18(3):380–392

    Article  CAS  PubMed  Google Scholar 

  20. Lee BB, Kim DI, Huh S, Kim HH, Choo IW, Byun HS et al (2001) New experiences with absolute ethanol sclerotherapy in the management of a complex form of congenital venous malformation. J Vasc Surg 33(4):764–772

    Article  CAS  PubMed  Google Scholar 

  21. Lee BB, Do YS, Byun HS, Choo IW, Kim DI, Huh SH (2003) Advanced management of venous malformation with ethanol sclerotherapy: mid-term results. J Vasc Surg 37(3):533–538

    Article  CAS  PubMed  Google Scholar 

  22. Lee BB (2003) Current concept of venous malformation (VM). Phlebolymphology 43:197–203

    Google Scholar 

  23. Lee BB, Do YS, Yakes W, Kim DI, Mattassi R, Hyun WS, Byun HS (2004) Management of arterial-venous shunting malformations (AVM) by surgery and embolosclerotherapy. A multidisciplinary approach. J Vasc Surg 39(3):590–600

    Article  PubMed  Google Scholar 

  24. Lee BB, Lardeo J, Neville R (2009) Arterio-venous malformation: how much do we know? Phlebology 24:193–200

    Article  CAS  PubMed  Google Scholar 

  25. Lee BB, Laredo J, Deaton DH, Neville RF (2009) Chapter 53. Arteriovenous malformations: evaluation and treatment. In: Gloviczki P (ed) Handbook of venous disorders: guidelines of the American Venous Forum, 3rd edn. A Hodder Arnold, London, pp 583–593

    Google Scholar 

  26. Jacob AG, Driscoll DJ, Shaughnessy WJ et al (1998) Klippel-Trenaunay syndrome: spectrum and management. Mayo Clin Proc 73(1):28–36

    Article  CAS  PubMed  Google Scholar 

  27. Lee BB (2005) Statues of new approaches to the treatment of congenital vascular malformations (CVMS) – single center experiences – (editorial review). Eur J Vasc Endovasc Surg 30(2):184–197

    Article  CAS  PubMed  Google Scholar 

  28. Gloviczki P, Driscoll DJ (2007) Klippel–Trenaunay syndrome: current management. Phlebology 22:291–298

    Article  CAS  PubMed  Google Scholar 

  29. Ziyeh S, Spreer J, Rossler J, Strecker R, Hochmuth A, Schumacher M, Klisch J (2004) Parkes Weber or Klippel-Trenaunay syndrome? Non-invasive diagnosis with MR projection angiography. Eur Radiol 14(11):2025–2029. Epub 2004 Mar 6

    Article  CAS  PubMed  Google Scholar 

  30. Wu ZQ (1993) Parkes-Weber’s syndrome: report of 5 cases. Zhonghua Wai Ke Za Zhi 31(12):749–751

    CAS  PubMed  Google Scholar 

  31. Courivaud D, Delerue A, Delerue C, Boon L, Piette F, Modiano P (2006) Familial case of Parkes Weber syndrome. Ann Dermatol Venereol 133(5 Pt 1):445–447

    Article  CAS  PubMed  Google Scholar 

  32. Park JH, Kim DI, Huh S, Lee SJ, Do YS, Lee BB (1998) Absolute ethanol sclerotherapy on cystic lymphangioma in neck and shoulder region. J Korean Vasc Surg Soc 14(2):300–303

    Google Scholar 

  33. Do YS, Yakes WF, Shin SW, Kim DI, Shin BS, Lee BB (2005) Ethanol embolization of arteriovenous malformations: interim results. Radiology 235(2):674–682

    Article  PubMed  Google Scholar 

  34. Lee BB (2008) Chapter 4. Lymphatic malformation. In: Tredbar LL, Morgan CL, Lee BB, Simonian SJ, Blondeau B (eds) Lymphedema-diagnosis and treatment. Springer, London, pp 31–42

    Chapter  Google Scholar 

  35. Ogita S, Tsuto T, Deguchi E et al (1991) OK-432 therapy for unresectable lymphangiomas in children. J Pediatr Surg 26:263–270

    Article  CAS  PubMed  Google Scholar 

  36. Kim KH, Kim HH, Lee SK, Lee BB (2001) OK-432 intralesional injection therapy for lymphangioma in children. J Korean Assoc Pediatr Surg 7:142–146

    Google Scholar 

  37. Luzzatto C, Midrio P, Tchaprassian Z, Guglielmi M (2000) Sclerosing treatment of lymphangiomas with OK-432. Arch Dis Child 82(4):316–318

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Al-Salem AH (2004) Lymphangiomas in infancy and childhood. Saudi Med J 25(4):466–469

    PubMed  Google Scholar 

  39. Stromberg BV, Weeks PM, Wray RC Jr (1976) Treatment of cystic hygroma. South Med J 69(10):1333–1335

    Article  CAS  PubMed  Google Scholar 

  40. Saijo M, Munro IR, Mancer K (1975) Lymphangioma. A long-term follow-up study. Plast Reconstr Surg 56(6):642–651

    Article  CAS  PubMed  Google Scholar 

  41. Lee BB, Bergan JJ (2002) Advanced management of congenital vascular malformations: a multidisciplinary approach. Cardiovasc Surg 10(6):523–533

    Article  PubMed  Google Scholar 

  42. Lee BB (2002) Advanced management of congenital vascular malformation (CVM). Int Angiol 21(3):209–213

    CAS  PubMed  Google Scholar 

  43. Jeon YH, Do YS, Shin SW, Liu WC, Cho JM, Lee MH, Kim DI, Lee BB, Choo SW, Choo IW (2003) Ethanol embolization of arteriovenous malformations: results and complications of 33 cases. J Kor Radiol Soc 49:263–270

    Google Scholar 

  44. Shin BS, Do YS, Lee BB, Kim DI, Chung IS, Cho HS et al (2005) Multistage ethanol sclerotherapy of soft-tissue arteriovenous malformations: effect on pulmonary arterial pressure. Radiology 235:1072–1077

    Article  PubMed  Google Scholar 

  45. Witte MH, Erickson R, Bernas M et al (1998) Phenotypic and genotypic heterogeneity in familial Milroy lymphedema. Lymphology 31:145–155

    CAS  PubMed  Google Scholar 

  46. Ferrell RE, Levinson KL, Esman JH, Kimak MA, Lawrence EC, Barmada MM et al (1998) Hereditary lymphedema: evidence for linkage and genetic heterogeneity. Hum Mol Genet 7:2073–2078

    Article  CAS  PubMed  Google Scholar 

  47. Michelini S, Degiorgio D, Cestari M et al (2012) Clinical and genetic study of 46 Italian patients with primary lymphedema. Lymphology 45(1):3–12

    CAS  PubMed  Google Scholar 

  48. Erickson RP (2001) Lymphedema-distichiasis and FOXC2 gene mutations. Lymphology 34(1):1–5

    CAS  PubMed  Google Scholar 

  49. Ghalamkarpour A, Holnthoner W, Saharinen P, Boon LM, Vikkula M et al (2009) Recessive primary congenital lymphoedema caused by a VEGFR3 mutation. J Med Genet 46:399–404

    Article  CAS  PubMed  Google Scholar 

  50. Karkkainen MJ, Ferrell RE, Lawrence EC, Kimak MA, Levinson KL, McTigue MA et al (2000) Missense mutations interfere with VEGFR-3 signalling in primary lymphoedema. Nat Genet 25:153–159

    Article  CAS  PubMed  Google Scholar 

  51. Lee BB, Mattassi R, Kim BT, Park JM (2005) Advanced management of arteriovenous shunting malformation (AVM) with transarterial lung perfusion scintigraphy (TLPS) for follow-up assessment. Int Angiol 24(2):173–184

    CAS  PubMed  Google Scholar 

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Lee, BB., Laredo, J., Neville, R.F. (2015). Lymphatic Vascular Malformations of the Limbs: Treatment of Extratruncular Malformations. In: Mattassi, R., Loose, D., Vaghi, M. (eds) Hemangiomas and Vascular Malformations. Springer, Milano. https://doi.org/10.1007/978-88-470-5673-2_49

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  • DOI: https://doi.org/10.1007/978-88-470-5673-2_49

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5672-5

  • Online ISBN: 978-88-470-5673-2

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