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Gynecology
Diagnosis
Vagina and Vulva
Benign Neoplasms
Vulvar Slow-Flow Vascular Malformation
Vulvar Slow-Flow Vascular Malformation
Douglas Rogers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Often referred to as cavernous hemangiomas in literature, although this is misnomer

          • Definitions

            • Vulvar lesions with thin-walled, dysplastic vascular channels of various sizes with associated hamartomatous stroma, phleboliths, and thrombi

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Carqueja IM et al: Vascular malformations: classification, diagnosis and treatment. Int Angiol. 37(2):127-42, 2018
                                  2. Yu BR et al: Genital tract cavernous hemangioma as a rare cause of postpartum hemorrhage. Obstet Gynecol Sci. 60(5):473-6, 2017
                                  3. Sapountzis S et al: Radical resection and reconstruction with bilateral gluteal fold perforator flaps for vulvar hemangiolymphangioma. Int J Gynaecol Obstet. 121(2):179-80, 2013
                                  4. Gray HJ et al: Painful clitoromegaly caused by rare epithelioid hemangioma. Gynecol Oncol Case Rep. 4:60-2, 2012
                                  5. Hosseinzadeh K et al: Imaging of the female perineum in adults. Radiographics. 32(4):E129-68, 2012
                                  6. Flors L et al: MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy follow-up. Radiographics. 31(5):1321-40; discussion 1340-1, 2011
                                  7. Madhu C et al: Vulval haemangioma in an adolescent girl. J Obstet Gynaecol. 31(2):187, 2011
                                  8. Bruni V et al: Hemangioma of the clitoris presenting as clitoromegaly: a case report. J Pediatr Adolesc Gynecol. 22(5):e137-8, 2009
                                  9. Djunic I et al: Diffuse cavernous hemangioma of the left leg, vulva, uterus, and placenta of a pregnant woman. Int J Gynaecol Obstet. 107(3):250-1, 2009
                                  10. Guida M et al: Pregnancy-induced symptomatic pelvic and extra-pelvic cavernous hemangiomatosis. Clin Exp Obstet Gynecol. 36(1):55-7, 2009
                                  11. Wang S et al: Venous malformations of the female lower genital tract. Eur J Obstet Gynecol Reprod Biol. 145(2):205-8, 2009
                                  12. Elsayes KM et al: Vascular malformation and hemangiomatosis syndromes: spectrum of imaging manifestations. AJR Am J Roentgenol. 190(5):1291-9, 2008
                                  13. da Silva BB et al: Vulvar epithelioid hemangioendothelioma. Gynecol Oncol. 105(2):539-41, 2007
                                  14. Gupta R et al: Benign vascular tumors of female genital tract. Int J Gynecol Cancer. 16(3):1195-200, 2006
                                  15. Erkek E et al: Clinical and histopathological findings in Bannayan-Riley-Ruvalcaba syndrome. J Am Acad Dermatol. 53(4):639-43, 2005
                                  16. Fernández-Aguilar S et al: Spindle cell vulvar hemangiomatosis associated with enchondromatosis: a rare variant of Maffucci's syndrome. Int J Gynecol Pathol. 23(1):68-70, 2004
                                  17. Olsen KI et al: Soft-tissue cavernous hemangioma. Radiographics. 24(3):849-54, 2004
                                  18. Bava GL et al: Life-threatening hemorrhage from a vulvar hemangioma. J Pediatr Surg. 37(4):E6, 2002
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Synonyms

                                            • Often referred to as cavernous hemangiomas in literature, although this is misnomer

                                          • Definitions

                                            • Vulvar lesions with thin-walled, dysplastic vascular channels of various sizes with associated hamartomatous stroma, phleboliths, and thrombi

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Gross Pathologic & Surgical Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Carqueja IM et al: Vascular malformations: classification, diagnosis and treatment. Int Angiol. 37(2):127-42, 2018
                                                                  2. Yu BR et al: Genital tract cavernous hemangioma as a rare cause of postpartum hemorrhage. Obstet Gynecol Sci. 60(5):473-6, 2017
                                                                  3. Sapountzis S et al: Radical resection and reconstruction with bilateral gluteal fold perforator flaps for vulvar hemangiolymphangioma. Int J Gynaecol Obstet. 121(2):179-80, 2013
                                                                  4. Gray HJ et al: Painful clitoromegaly caused by rare epithelioid hemangioma. Gynecol Oncol Case Rep. 4:60-2, 2012
                                                                  5. Hosseinzadeh K et al: Imaging of the female perineum in adults. Radiographics. 32(4):E129-68, 2012
                                                                  6. Flors L et al: MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy follow-up. Radiographics. 31(5):1321-40; discussion 1340-1, 2011
                                                                  7. Madhu C et al: Vulval haemangioma in an adolescent girl. J Obstet Gynaecol. 31(2):187, 2011
                                                                  8. Bruni V et al: Hemangioma of the clitoris presenting as clitoromegaly: a case report. J Pediatr Adolesc Gynecol. 22(5):e137-8, 2009
                                                                  9. Djunic I et al: Diffuse cavernous hemangioma of the left leg, vulva, uterus, and placenta of a pregnant woman. Int J Gynaecol Obstet. 107(3):250-1, 2009
                                                                  10. Guida M et al: Pregnancy-induced symptomatic pelvic and extra-pelvic cavernous hemangiomatosis. Clin Exp Obstet Gynecol. 36(1):55-7, 2009
                                                                  11. Wang S et al: Venous malformations of the female lower genital tract. Eur J Obstet Gynecol Reprod Biol. 145(2):205-8, 2009
                                                                  12. Elsayes KM et al: Vascular malformation and hemangiomatosis syndromes: spectrum of imaging manifestations. AJR Am J Roentgenol. 190(5):1291-9, 2008
                                                                  13. da Silva BB et al: Vulvar epithelioid hemangioendothelioma. Gynecol Oncol. 105(2):539-41, 2007
                                                                  14. Gupta R et al: Benign vascular tumors of female genital tract. Int J Gynecol Cancer. 16(3):1195-200, 2006
                                                                  15. Erkek E et al: Clinical and histopathological findings in Bannayan-Riley-Ruvalcaba syndrome. J Am Acad Dermatol. 53(4):639-43, 2005
                                                                  16. Fernández-Aguilar S et al: Spindle cell vulvar hemangiomatosis associated with enchondromatosis: a rare variant of Maffucci's syndrome. Int J Gynecol Pathol. 23(1):68-70, 2004
                                                                  17. Olsen KI et al: Soft-tissue cavernous hemangioma. Radiographics. 24(3):849-54, 2004
                                                                  18. Bava GL et al: Life-threatening hemorrhage from a vulvar hemangioma. J Pediatr Surg. 37(4):E6, 2002