McCafferty IJ, Jones RG Imaging and management of vascular malformations. Clinical Radiol. 2011; 66:1208-1218
Kilcline C, Frieden IJ Infantile hemangiomas: how common are they? A systematic review of the medical literature. Pediatr Dermatol. 2008; 25:168-173
Chang LC, Haggstrom AN, Drolet BA Growth characteristics of infantile hemangiomas: implications for management. Pediatrics. 2008; 122:360-367
Dubois J, Garel L, David M, Powell J Vascular soft-tissue tumors in infancy: distinguishing features on Doppler sonography. Am J Roentgenol. 2002; 178:1541-1545
Patino-Seijas B, Lorenzo-Franco F, Rey-Sanjurjo JL, González-Cuesta M, López-Cedrún Cembranos JL Vascular lesions: GLUT-1 expression as a diagnostic tool to discriminate tumours from malformations. J Oral Maxillofac Surg. 2012; 70:2333-2342
Mussalli NG, Hopps RM, Johnson NW Oral pyogenic granuloma as a complication of pregnancy and the use of hormonal contraceptives. Int J Gynaecol Obstet. 1976; 14:187-191
Sternberg SS, Antonioli DA, Carter D, Mills SE, Oberman H, 3rd edn. Philadelphia: Lippincott Williams & Wilkins; 1999
Sills ES, Zegarelli DJ, Hoschander MM, Strider WE Clinical diagnosis and management of hormonally responsive oral pregnancy tumour (pyogenic granuloma). J Reprod Med. 1996; 41:467-470
Taira JW, Hill TL, Everett MA Lobular capillary haemangioma (pyogenic granuloma) with satellitosis. J Am Acad Dermatol. 1992; 27:297-300
White JM, Chaudhry SI, Kudler JJ, Sekandari N, Schoelch ML, Silverman S Nd: YAG and CO2 laser therapy of oral mucosal lesions. J Clin Laser Med Surg. 1998; 16:299-304
Ishida CE, Ramos-e-Silva M Cryosurgery in oral lesions. Int J Dermatol. 1998; 37:283-285
Moon SE, Hwang EJ, Cho KH Treatment of pyogenic granuloma by sodium tetradecyl sulphate sclerotherapy. Arch Dermatol. 2005; 141:644-646
Izikson L, Nelson JS, Anderson RR Treatment of hypertrophic and resistant port wine stains with a 755nm laser: a case series of 20 patients. Lasers Surg Med. 2009; 41:427-432
Chapas AM, Eickhorst K, Geronemus RG Efficacy of early treatment of facial port wine stains in newborns: a review of 49 cases. Lasers Surg Med. 2007; 39:563-568
Garro SJ, Bradshaw WT Sturge-weber syndrome: a case study. Adv Neonatal Care. 2014; 14:96-102
Vikkula M, Boon LM, Mulliken JB Molecular genetics of vascular malformations. Matrix Biol. 2001; 20:327-335
Dubois J, Soulez G, Olivia VL, Berthiaume MJ, Lapierre C, Therasse E Soft-tissue venous malformations in adult patients: imaging and therapeutic issues. Radiographics. 2001; 21:1519-1531
Legiehn GM, Heran MK Classification, diagnosis and interventional radiologic management of vascular malformations. Orthop Clin North Am. 2006; 37:435-474
Cohen MM Vascular update: morphogenesis, tumours, malformations, and molecular dimensions. Am J Med Genet A. 2006; 140:2013-2038
Jussila L, Alitalo K Vascular growth factors and lymphangiogenesis. Physiol Rev. 2002; 82:673-700
Emery PJ, Bailey CM, Evans JN Cystic hygroma of the head and neck. A review of 37 cases. J Laryngol Otol. 1984; 98:613-619
Puig S, Casati B, Studenherz A, Paya K Vascular low-flow malformations in children: current concepts for classification, diagnosis and therapy. EurJ Radiol. 2005; 53:35-45
Kim SW, Kavanagh K, Orbach DB, Alomari AL, Mulliken JB, Rahbar R Long-term outcome of radiofrequency ablation for intraoral microcystic lymphatic malformation. Arch Otolaryngol Head Neck Surg. 2011; 137:1247-1250
Houdart E, Gobin YP, Casasco A, Aymard A, Herbreteau D, Merland JJ A proposed angiographic classification of intracranial arteriovenous fistulae and malformations. Neuroradiology. 1993; 35:381-385
Vascular anomalies constitute a diffuse group of conditions which can range in their significance from being completely harmless and of little clinical relevance to being potentially life threatening. It is important that dentists have a good understanding of these conditions so that the risk of potential complications of dental treatment in affected patients is reduced as much as possible. This article focuses on the pathogenesis, diagnosis and treatment of these conditions, with explanation on their relevance to the practising dentist.
CPD/Clinical Relevance: The paper describes several vascular anomalies that may be encountered in clinical practice with information that is relevant to their diagnosis and management.
Article
The umbrella term ‘vascular anomalies’ encompasses both ‘vascular malformations’ and ‘vascular tumours’ which are clinically distinct entities. Historically, there has been some confusion around the terminology used to describe the lesions and various attempts have been made to come up with a definitive classification of the conditions. The most widely accepted classification today is the ‘modified Mulliken Classification’1 (Figure 1).
Vascular tumours are true neoplasms that exhibit pathologic vascular endothelial cell proliferation. Most of these are either infantile haemangiomas or congenital haemangiomas which differ in their clinical course.
Infantile haemangiomas are the most common tumours of the head and neck in infants, affecting around 3–5% of children, females being affected more than males with a ratio of 3:1.2
At birth they are either undetectable or visible only as a precursor lesion. Typically, they manifest themselves clinically several weeks after birth, proliferating rapidly. In 80% of cases, the lesions finish growing by the time the child is 5 months old.3 When located superficially they appear as firm, isolated, raised, dark red lesions of the skin. If located as deeper masses in subcutaneous tissue, they may produce a blue hue in unaffected overlying skin. Colour Doppler ultrasound imaging is useful to visualize the features of these lesions and distinguish them from other vascular tumours.4 Immunohistochemistry can distinguish infantile haemangiomas from other vascular tumours or malformations due to the fact that infantile haemangiomas show positivity for the protein ‘glucose transporter-1’.5
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