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Misconceptions and Misdiagnoses in Evaluation and Management of Peripheral Vascular Malformations: A Pictorial Essay
Nolan C. Cirillo-Penn, BA, Samuel Kogan, BA, Susan Murphy, MD, Mitchell Simon, MD, Naiem Nassiri, MD.
Rutgers Robert Wood Johnson Vascular Anomalies & Malformations Program (VAMP), New Brunswick, NJ, USA.
OBJECTIVES:
To highlight a tertiary referral center’s experience with commonly encountered errors in the workup of peripheral vascular malformations from outside referrals. An attempt is made to raise awareness of these common diagnostic and therapeutic pitfalls to help expedite accurate diagnosis, proper imaging workup, and appropriate treatment.
METHODS:
Over a 1-year period, all referrals to the Rutgers Robert Wood Johnson Vascular Anomalies & Malformations Program (VAMP) with erroneous initial diagnoses with/without suboptimal initial imaging and/or treatment were retrospectively reviewed. These initial diagnostic mishaps, their associated complications and mistreatments are highlighted and expanded upon with a focus on classification, nomenclature, clinical, and radiologic images. Furthermore, an algorithm for proper nomenclature, imaging, and treatment is provided in detail.
RESULTS:
Table 1
CONCLUSIONS:
Errors in nomenclature and inconsistent classification schemes continue to plague vascular anomalies and can be a major source of patient morbidity and frustration. Increased awareness of proper nomenclature and classification, appropriate imaging modalities, and available therapeutic options can have a positive impact on clinical outcomes. A collaborative, multidisciplinary approach at a dedicated center of excellence remains the ideal therapeutic environment for these patients.
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