Diagnostic dilemma in vascular mal-formation of the upper lip: a case report and review of literature

Abstract

Background: Vascular lesions are broad term used for a wide range of conditions that results in abnormal number, structure, or position of blood vessels now widely divided in two groups; vascular tumors and vascular malformations. These lesions could be clinically diagnosed with 90% accuracy, however radiographic evaluation such as CT and MRI angiograms may be helpful in determining the extent, exact location and flow dynamics of some lesions. This is important because appropriate treatment and prognosis depend largely on the type of lesion. While vascular tumor is known to respond to steroid therapy, vascular malformations do not. Aim: To present a case of vascular lesion on the upper lip and its management. Methods: We present a case of arterio-venous malformation on the upper lip in a 20 year old female and its surgical management. Findings: Our case posed a diagnostic and management challenge initially diagnosed as haemangioma, but was eventually diagnosed as vascular malformation with immuno-histochemistry supplemented by CT and MRI angiograms and managed. Definitive treatments undertaken were bilateral upper labial arterial ligation, excision of the lesion and cheilorrhaphy. Conclusion: The patient now has an aesthetically acceptable, functioning upper lip. This demonstrates the advantage of using advanced diagnostic aids in diagnosis and surgical management. Key words: Diagnostic dilemma, vascular malformation, vascular tumors, haemangioma, upper lip.