Plastic Surgery for Capillary Malformations Workup

Updated: Oct 21, 2020
  • Author: Rohit Seth, MD, PhD, MRCS(Edin); Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Workup

Approach Considerations

Cases should be discussed in a formal multidisciplinary meeting involving plastic surgery, pediatrics, dermatology, interventional radiology, hematology, physiotherapy, and histopathology.

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Imaging Studies

Most lesions do not require investigation; for concerning lesions, however, appropriate imaging studies include ultrasonography (US), computed tomography (CT) scanning, magnetic resonance imaging (MRI), and spinal radiography. [14]

Magnetic resonance angiography can be used to help document the presence or absence of enlarged vessels in vascular anomalies.

Doppler studies can be used to evaluate the flow pattern of the lesion. Arterial malformations demonstrate high flow; this is a noninvasive method of differentiating them from capillary malformations

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Histologic Findings

Ultrastructural characteristics and endothelial mitotic activity are normal in capillary malformations. Typical Weibel-Palade bodies, smooth endoplastic reticulum, and fenestrated postcapillary venules may be observed using electron microscopy. Capillary malformations do not stain for GLUT-1, a marker for infantile hemangiomas, so this test can be used to distinguish between the two lesions. [3, 4]

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Other Tests

Ophthalmologic examination should be performed if there is periocular involvement, being carried out every 6 months for the first 3 years and then annually. [11]

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