Magnetic resonance imaging has been reported to be a reliable and accurate tool for delineating and accurate characterisation of vascular malformations. Herborn et al found STIR images to be helpful in delineating vascular malformations and that the fluid filled vascular structure appeared bright due to inherent signal characteristic of this sequence. Time resolved 3D MR angiography was found to yield important data for accurate classficiation of vascular malformations as well as data regarding feeding and draining vessels.
We present two cases of non-vascular anomaly tumors masquerading as vascular malformations leading to potential delay in management or treatment resulting in complications.
Two young patients were referred as vascular malformations and were concluded clinically and radiologically as venous malformation and macrocystic lymphatic malformation. Treament options including alcohol scleortherapy were considered. The lesions were excised surgically and on histology the lesions were reported as giant cell fibroblastoma and plexiform neurofibroma respectively.
As vascular malformations are commonly encountered in interventional radiology and pediatric plastic surgery arenas, these cases raises an important caution in the diagnosis and management of an apparently benign congenital vascular anomaly
Other solid tumors can appear as medium signal intensity on T1 and bright on T2 stir images with variable contrast enhancement. Vascular malformations also appear as having low to intermediate intensity T1 and hight signal intensity on T2 images and may enhance with contrast.
Magnetic resonance imaging with contrast may not reliably differentiate between solid tumors and vascualr malformations as signals may vary. High index of clinical suspicion should accompany lesions that exhibit atypical features or arise in atypical anatomical regions.