Separate vascular tumours (infantile haemangioma — grows then involutes) from malformations (present at birth, grow with the child), then slow-flow (venous, lymphatic, capillary) from fast-flow (arteriovenous) — the class decides sclerotherapy, embolisation or observation.
Orient first
- ISSVA classification (verify current version).
- Venous malformation: phleboliths, compressible, slow gradual enhancement.
- Lymphatic malformation: macrocystic with fluid levels, septal enhancement only; AVM: flow voids, arterialised veins, no mass.
Acquire the study
- High-frequency linear probe; colour and spectral Doppler; compression.
The manoeuvre
- Compressibility and phleboliths (echogenic foci with shadowing) — venous malformation.
- Cysts with septa and no flow — lymphatic malformation.
- Spectral Doppler: low-resistance arterial flow and arterialised veins — AVM; solid mass with high vessel density — haemangioma.
- Size in cm and depth (fascia, muscle).
What confirms it
- A flow type and ISSVA class consistent with the clinical history.
What licenses you to exclude it
- A solid enhancing mass that does not fit a haemangioma needs biopsy.
The classic misread
- Calling a thrombosed venous malformation a solid tumour.