Ufuk Furkan
From the Department of Radiology, University of Pamukkale, Pamukkale University Medical School, Kinikli, 20100 Denizli, Turkey.
Radiology. 2021 Jan;298(1):228-230. doi: 10.1148/radiol.2020192802.
History An 8-year-old girl presented to our hospital with painful swelling of the left thigh and soft-tissue swelling in the right chest wall. The patient's history revealed that the swelling had been present since birth but had grown slowly. She had no history of relevant trauma. Her blood pressure was 145/95 mmHg (normal value, <115/76 mmHg), and her heart rate was 105 beats per minute (normal value, 75-118 beats per minute). The patient's electrocardiogram displayed sinus tachycardia. Physical examination revealed soft-tissue hypertrophy in the left thigh and right lower chest wall. A painful soft and flexible mass measuring approximately 5 × 6 × 15 cm (in the anteroposterior, transverse, and craniocaudal directions, respectively) was detected at the left thigh. Moreover, a painless soft mass measuring approximately 3 × 8 × 10 cm (in the anteroposterior, transverse, and craniocaudal directions, respectively) was detected in the right lower chest wall, and the overlying skin was intact. Pink macules with a 3-cm diameter on the anterior left superior thigh and a 2.5-cm diameter in the left inguinal region were detected. Examination of other systems, including the cardiovascular system, revealed normal findings. Laboratory test results were within normal limits. Abdominal US showed perirenal vascular collaterals, and musculoskeletal US of the left thigh revealed vascular collaterals (images not shown). Therefore, thoracoabdominal CT angiography (Fig 1a-1c) and contrast material-enhanced MRI of the bilateral thigh (Fig 2a-2c) were performed.
病史 一名8岁女孩因左大腿疼痛性肿胀及右胸壁软组织肿胀前来我院就诊。患者病史显示肿胀自出生即存在，但生长缓慢。她无相关外伤史。其血压为145/95 mmHg（正常值，<115/76 mmHg），心率为每分钟105次（正常值，75 - 118次/分钟）。患者心电图显示窦性心动过速。体格检查发现左大腿及右下胸壁软组织肥厚。在左大腿处检测到一个疼痛性柔软且可活动的肿块，大小约为5×6×15 cm（分别为前后径、横径和头尾径）。此外，在右下胸壁检测到一个无痛性柔软肿块，大小约为3×8×10 cm（分别为前后径、横径和头尾径），其上覆盖皮肤完整。在左大腿前上方检测到直径3 cm的粉红色斑疹，在左腹股沟区检测到直径2.5 cm的粉红色斑疹。包括心血管系统在内的其他系统检查结果均正常。实验室检查结果在正常范围内。腹部超声显示肾周血管侧支，左大腿肌肉骨骼超声显示血管侧支（未展示图像）。因此，进行了胸腹CT血管造影（图1a - 1c）及双侧大腿对比剂增强MRI（图2a - 2c）检查。
