Microvascular proliferation in vascular malformations of skin and soft-tissue Implications for classification and diagnosis

This thesis delves into microvascular proliferations (MVP) within congenital vascular malformations, questioning the validity of the ISSVA classification. The study has two main parts.
Part 1 explores vascular malformations, particularly arteriovenous malformations (AVM), which often involve angiogenesis, significantly affecting patients. MVP factors include genetic mutations, treatment effects, and hormonal influences. Though targeted drug therapies show promise, limited research calls for further investigation.
Our interest in hormonal influences on MVP in AVM led to a study revealing hormone receptors in MVP areas, hinting at a link to disproportionate growth during hormonal changes. These findings guide molecular research and potential AVM recurrence reduction through modified hormonal therapies.
A unique case study follows a 24-year-old pregnant woman with AVM in her left index finger, confirming hormone receptors in MVP areas and suggesting a role for pregnancy-related hormonal activity in AVM progression.
Additionally, we explore non-involuting congenital hemangiomas (NICH) and their relation to vascular malformations. Distinct marker expression patterns raise questions about NICH's classification as congenital vascular malformations. NICH exhibits persistent vasoproliferation, challenging traditional categorization.
These findings shed light on angiogenesis, hormonal influences, and complex vascular malformations, offering insights for further research and clinical understanding.
Part 2 focuses on validating the ISSVA classification's applicability in diverse clinical settings, emphasizing histopathological aspects of vasoproliferative activity and lymphatic differentiation in the lesions.