Surgical treatment of hemangiomas and arteriovenous malformations in upper extermity

Hemangiomas belong to one of the most common type of tumors occurring in childhood. They are benign and often do not require any treatment, with the tendency to. frequently disappearing spontaneously at the age of 5-7 years. The tumors usually develop in the head and neck area, whereas vascular malformations (AVMs) are rare congenital anomalies, which may occur anywhere. In upper limb, they may amount to 30-60% of cases. It is common for these changes not to require any surgical treatment. In case they do, the main indications for such treatment of upper limb AVMs may be as follows: signs of compression of the peripheral nerves, limited mobility of the fingers because of the tumor, which entails difficulties in the functioning of the whole arm, pain and aesthetic considerations.

was to present the results of surgical treatment of vascular tumors (hemangiomas and AVMs) in the upper limb that was applied in our department, as well as a broader discussion on epidemiology, diagnosis, and treatment of these changes.

In 2003-2011 period we treated 11 patients aged 24-39, suffering from vascular tumors (hemangiomas / vascular malformations) in the upper limb; the group included 3 men and 8 women. In this group we diagnosed 2 cases with arm hemangiomas, 2 cases of intramuscular hemangiomas of the forearm, 2 cases of hemangiomas in metacarpal area, 2 cases of AVMs of the finger and metacarpal area, and 4 cases of isolated vascular malformations (mainly arteriovenous malformations) of the fingers. All preparations were examined histologically.

No complications or recurrence were found in 7 cases, recurrences of AVMs were observed in 4 patients with finger changes. In one patient with AVMs of the index finger, we observed a treble recurrence, which severely impaired functioning of his hand. We eventually suggested to him the finger amputation, to which the patient agreed.

Upper extremity is a rare location of hemangiomas and other vascular malformations requiring surgery. hemangiomas are more common in women, and the occurrence of AVMs in both males and females is similar. Surgical treatment of hemangiomas and AVMs of the upper extremities is doubtlessly an arduous task, which calls for great microsurgical skills.