case_images: PMC11045289_01
case_images: (a, b) Bluish telangiectatic pattern from the lumbar area to bilateral lower extremities associated with dark bluish-purple discoloration in the soles at one day of life.
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case_images: fig1
case_images: Her mother noticed diffuse bluish discoloration with a telangiectatic pattern on bilateral lower extremities and feet, extending to the lumbar area (Figures 1(a) and 1(b)).
case_images: (a, b) Erythematous, purulent, and confluent ulcers at the lumbar, gluteal, and genital areas at one month of life.
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case_images: PMC11045289_01_CRIPE2024-7501793.002.jpg
case_images: fig2
case_images: Physical examination was remarkable for mottled and reticulated lower extremities that extended to the lumbar area with confluent ulcers (Figures 2(a) and 2(b)) and a lateral right well-demarcated ankle ulcer (Figure 3).
case_images: 2 cm x 1 cm deep erythematous well-demarcated ulcer in the lateral right ankle at one month of life.
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case_images: fig3
case_images: Physical examination was remarkable for mottled and reticulated lower extremities that extended to the lumbar area with confluent ulcers (Figures 2(a) and 2(b)) and a lateral right well-demarcated ankle ulcer (Figure 3).
case_images: (a) Avidly enhancing rounded structure with intermediate T2 signal and mild restricted diffusion seen in the retroperitoneum between the aorta and SMA, and inferomedial to the expected position of the pancreatic head, anterior to the IVC vein measuring approximately 2.6 cm AP x 2.5 cm transverse x 2.6 cm. (b) Ill-defined enhancing structure, with marked T2 hyperintensity and no restricted diffusion in the left adrenal region measuring approximately 1.5 x 2.3 by 2.3 cm, abutting the left renal upper pole, without a definite fat plain between them. (c) Left paraspinal mass (grossly at the level of T8-T10) with enhancement, high T2 signal, and mild restricted diffusion approximately 6 mm AP x 2.1 cm TR x 2 cm long. There is mild extension to the left T7-T8 neural foramen without appreciable expansion.
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case_images: fig4
case_images: An abdominopelvic MRI was performed to assess common extracutaneous IH locations and was remarkable for an ill-defined posterior perirectal region that was correlated with a gluteal hemangioma and enhancing lesions at the retroperitoneum, left adrenal, and left paraspinal area that were compatible with additional IHs (Figures 4(a)-4(c)).
case_images: Merely diffuse significant bowel wall thickening and hyperenhancement throughout most of the small and large bowel. No free air identified.
case_images: CRIPE2024-7501793.005.jpg
case_images: PMC11045289_01_CRIPE2024-7501793.005.jpg
case_images: fig5
case_images: This MRI also revealed nearly diffuse thickening and hyperenhancement of the bowel wall, suggesting infiltrating intestinal hemangiomatosis (Figure 5).