case_images: PMC10834692_01
case_images: (A) Prenatal MRI shows a mass lesion with a high T2WI signal in the right abdomen (arrow) compressing the adjacent small bowel loops. (B,C) Follow-up MRI reveals a nodular lesion (arrows) with hypointensity in the T2WI sequence and hyperintensity in the T1WI sequence. (D) One tiny, calcified spot (arrow) in the pre-contrast CT images.
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case_images: F1
case_images: At 26 weeks, the prenatal magnetic resonance imaging (MRI) was performed and showed a defined mass lesion in the right abdomen compressing the adjacent small bowel loops (Figure 1A). Some possible calcified spots with high T1WI signals and low T2WI signals were also noted within the mass (Figures 1B,C). Lymphatic-venous malformation (LVM) was strongly suspected (Figure 1D).
case_images: The port-wine stains (capillary malformations) on the left thigh.
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case_images: F2
case_images: Physical examination revealed mild hemihypertrophy of the left lower extremity and red lesions on the left thigh (Figure 2).
case_images: An MRI of the tubular structure at the anterior subcutis of the left thigh reveals (A) a signal void (arrows) in PDWI and (B) homogeneous strong enhancement (arrows) in the T1WI + C sequence. (C) Contrast-enhanced CT shows an engorged tubular structure (arrows) on the lateral aspect of the left lower limb that extends from the lower leg to the gluteal and pelvic regions.
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case_images: F3
case_images: The tubular lesion displayed a signal void and homogeneous strong enhancement, compatible with a vascular malformation (Figures 3A,B). Servelle (Figure 3C). Subcutaneous soft tissue stranding and edematous change from the left thigh to calf were also noted.
case_images: Microscopically, there are dilated capillaries (black arrows), lymphatics (blue arrows) and venules (red arrows) in the papillary dermis, reticular dermis and subcutis, shown by hematoxylin and eosin stain (H & E stain, A), D2-40 (B) and CD31 (C) stains. The blood vessels are negative for Glut1 (D) therefore exclude the diagnosis of infantile hemangioma. GLUT-1, Endothelial glucose transporter 1.
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case_images: F4
case_images: A biopsy of the left thigh lesion was performed and the pathology revealed capillary-lymphatic-venous malformation (CLVM) (Figure 4).
case_images: PMC10834692_02