Klippel-Trénaunay-Weber syndrome

Case contributed by Michael P. Hartung
Diagnosis certain

Presentation

Multiple scans for disease evaluation.

Patient Data

Age: 30 years
Gender: Male

CT abdomen/pelvis

ct
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
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Info

Splenic hemangiomatosis. Right retroperitoneal venous/lymphatic malformations with small phleboliths. Extensive venous/lymphatic malformations in the right flank, scrotum, and imaged right lower extremity. 

MR Pelvis

mri
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal
T1 C+
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Axial T2
fat sat
This study is a stack
Sagittal
T2 fat sat
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Contrast-enhanced and T2-weighted fat-suppressed imaging of the pelvis demonstrating multiple venous and lymphatic malformations. 

MRA

mri
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
This study is a stack
Coronal
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Info

MRA TRICKS demonstrating sequential filling of multiple right lower extremity venous malformations. 

MR right knee

mri
This study is a stack
Axial
STIR
This study is a stack
Coronal
T1
This study is a stack
Coronal
STIR
This study is a stack
Sagittal
T1
This study is a stack
Sagittal
STIR
This study is a stack
Axial
STIR
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Info

Multiple MRI sequences of the right knee showing hypertrophy of the lower extremity with numerous venous and lymphatic malformations. 

Case Discussion

Klippel-Trénaunay-Weber syndrome is diagnosed with at least two of these three features are present: capillary malformations, soft tissue or bone hypertrophy, and varices or venous malformations. Most cases are sporadic. Most cases involve the lower limb as the site of malformations. 

These patients are at risk for sequestration of platelets, resulting in Kasabach-Merritt syndrome (a consumptive coagulopathy). They can also suffer from stasis dermatitis, thrombophlebitis, cellulitis, congestive heart failure, bleeding, and thromboembolic events. 

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