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Vascular malformation rupture in a patient affected by Costello syndrome

Authors :
Francesca Barbieri
Ignacio Fernando Hall
Leonardo Elia
Efrem Civilini
Source :
BMJ case reports. 15(12)
Publication Year :
2024

Abstract

Costello syndrome (CS) is a rare genetic syndrome affecting multiple organs, generally caused by mutations of theHRASgene, belonging to theRAS/MAPKgenes family.A male patient with CS developed a painful pulsatile mass on the lateral side of the wrist. An initial ultrasonographic investigation confirmed the presence of a radial artery lesion, possibly an arterial aneurysm. On surgical resection, histological evaluation showed a tangle of vascular structures with variable calibre and abnormal wall histology. Immunohistochemical stainings revealed a very poor endothelial contribution to the central vascular wall structure. These histological observations led us to conclude we had managed an acute vascular malformation (VM) rupture, rather than a common arterial aneurysmal condition. Considering the molecular mechanisms regulated byRAS/MAPKgenes, CS patients might have a higher risk of developing VMs and, in the presence of a pulsatile mass with acute onset, VM rupture should be considered.

Details

ISSN :
1757790X
Volume :
15
Issue :
12
Database :
OpenAIRE
Journal :
BMJ case reports
Accession number :
edsair.doi.dedup.....15497427296d6853e135610211567158