2015 HSC Section 1 Book of Articles

A. Tekes et al. / Clinical Radiology 69 (2014) 443 e 457

Figure 7 (a) A 4-year-old male patient with a large, fi rm mass on his right shoulder/chest wall. It was fi rst noted soon after birth, and he underwent surgical debulking at that time. A known LM that recently enlarged in size. (b e c) Coronal T2-weighted image with fat saturation shows a T2 bright multicystic/septate, large mass that only shows enhancement of the cyst walls and septa (c), typical for LMs. Relatively large size of each cyst quali fi es for a macrocystic LM. (d) Ultrasound during percutaneous access demonstrates macrocystic LM. (e) Contrast medium injection into one of three macrocysts being treated with doxycycline sclerotherapy.

ill-de fi ned purpuric mass, often painful; however, presen- tation may be later in childhood. 24 The destructive/in fi l- trative nature and very rapid growth of the vascular tumour helps differentiation from IH. Kasabach e Merritt phenom- enon (KMP) can be seen up to 50% of patients. KHE has a high mortality rate (24%) related to coagulopathy or com- plications from local tumour in fi ltration. The fi rm,

indurated lesion has a more invasive appearance and pur- plish colouration ( Figs 1 and 5 ). These cells form slit-like lumina containing erythrocytes that resemble Kaposi ’ s sarcoma, thus the name KHE. 25 KHE appears as a solid mass with ill-de fi ned borders and vari- able echogenicity at US. 26 MRI demonstrates an in fi ltrative pattern with crossing of multiple soft-tissue planes with

Figure 8 Two patients with Sturge e Weber, (a) 23 years-old, and (b) 35 years old, both with extensive CMs of the face. Note the thickening of the CM especially in b, which can be seen in CMs over time.

250