Of these, capillary malformations are the most common but rarely require imaging for diagnosis because of their characteristic cutaneous manifestations [3,4]. Venous and lymphatic malformations have a reported prevalence of 1% in the general population with 40% involving the extremities [6]. Although symptomatology is variable, these lesions may present with focal or more generalized extremity pain, swelling, or compressible mass with or without associated skin discoloration. Involvement of the deep tissues, including bone, is not uncommon, and physical examination often underestimates their full extent [2,5]. Vascular tumors are subclassified based on propensity for aggressive and malignant behavior; however, the majority are benign [3]. Infantile hemangiomas are among the most common type of vascular neoplasm. These benign lesions present in infancy or early childhood and demonstrate rapid proliferative growth followed by eventual involution, most often not requiring treatment [7]. Less commonly, vascular tumors such as the intramuscular hemangioma, can present in adulthood with swelling, pain, or mass. The diagnosis of a vascular malformation or neoplasm is frequently made clinically when classic signs and symptoms are present. Imaging is used for confirmation, particularly if the clinical presentation is atypical or vague [3,8] and is generally required for characterization of these lesions. Imaging also plays a critical role in treatment planning, which is often required because of growth, limb deformity, and decreased function, as well as pain. Lesion characteristics such as subtype (high flow versus low flow), depth, and invasion of adjacent structures, as well as inflow and outflow vessels, help in optimal treatment selection [9]. Treatment approach spans the spectrum of conservative to aggressive options, which include compression dressings, sclerotherapy,
Clinically Suspected Vascular Malformation of the Extremities. Of these, capillary malformations are the most common but rarely require imaging for diagnosis because of their characteristic cutaneous manifestations [3,4]. Venous and lymphatic malformations have a reported prevalence of 1% in the general population with 40% involving the extremities [6]. Although symptomatology is variable, these lesions may present with focal or more generalized extremity pain, swelling, or compressible mass with or without associated skin discoloration. Involvement of the deep tissues, including bone, is not uncommon, and physical examination often underestimates their full extent [2,5]. Vascular tumors are subclassified based on propensity for aggressive and malignant behavior; however, the majority are benign [3]. Infantile hemangiomas are among the most common type of vascular neoplasm. These benign lesions present in infancy or early childhood and demonstrate rapid proliferative growth followed by eventual involution, most often not requiring treatment [7]. Less commonly, vascular tumors such as the intramuscular hemangioma, can present in adulthood with swelling, pain, or mass. The diagnosis of a vascular malformation or neoplasm is frequently made clinically when classic signs and symptoms are present. Imaging is used for confirmation, particularly if the clinical presentation is atypical or vague [3,8] and is generally required for characterization of these lesions. Imaging also plays a critical role in treatment planning, which is often required because of growth, limb deformity, and decreased function, as well as pain. Lesion characteristics such as subtype (high flow versus low flow), depth, and invasion of adjacent structures, as well as inflow and outflow vessels, help in optimal treatment selection [9]. Treatment approach spans the spectrum of conservative to aggressive options, which include compression dressings, sclerotherapy,