20.500.12556/DiRROS-28726 Vulvar vascular malformations diagnosis, imaging, and management - a review with an illustrative case Background: Vascular malformations are congenital structural abnormalities of the blood vessels that may present at any age. In the vulvovaginal region, these lesions are uncommon and frequently misdiagnosed because their clinical appearance overlaps with common gynecologic conditions, particularly Bartholin’s gland cyst or abscess. Inappropriate surgical intervention without prior vascular evaluation may result in hemorrhage, incomplete treatment, and recurrence. Methods: A structured narrative review of the literature was performed using PubMed/MEDLINE and EMBASE databases (January 2000–April 2024) to summarize the classification, pathophysiology, clinical presentation, imaging characteristics, differential diagnosis, and management of vulvovaginal vascular malformations. Publications addressing vascular anomalies in other anatomical locations were also included when clinically relevant. A representative clinical case confirmed by histopathologic and molecular analysis is presented to illustrate the diagnostic pitfalls. Results: Vulvovaginal vascular malformations are predominantly low-flow venous lesions but may include high-flow arteriovenous malformations. A clinical examination alone is insufficient for diagnosis. Doppler ultrasonography is the recommended initial imaging modality, followed by magnetic resonance imaging to define the lesion extent and flow characteristics. Misdiagnosis most commonly occurs when lesions are treated as Bartholin’s gland pathology without prior imaging. Low-flow lesions are generally managed with sclerotherapy or planned surgical excision, whereas high-flow lesions require embolization and multidisciplinary care. Hormonal and hemodynamic changes, including pregnancy, may precipitate enlargement or thrombosis. Conclusions: Vascular malformations should be considered in the differential diagnosis of atypical vulvar masses. Preoperative imaging is essential in order to avoid inappropriate surgical procedures. A structured diagnostic approach combining clinical assessment and imaging enables correct classification and guides treatment. The presented case demonstrates a typical diagnostic pitfall and emphasizes the importance of recognizing vascular lesions in gynecologic practice. malformations venous malformation arteriovenous malformation vulva Bartholin gland Doppler ultrasound MRI differential diagnosis sclerotherapy malformacije venska malformacija arteriovenska malformacija vulva Bartholinova žleza Dopplerjev ultrazvok MRI diferencialna diagnoza skleroterapija true false true Angleški jezik Slovenski jezik Neznano 2026-03-31 11:44:21 2026-03-31 11:44:22 2026-04-01 03:58:39 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 31. 3. 2026; str. 1-22 issue 2, [article no. 16] Vol. 5 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 618.1 2813-2475 10.3390/jvd5020016 273703683 RAZ_Batkoska_Marija_2026.pdf RAZ_Batkoska_Marija_2026.pdf 1 A06CBE9FD91DCFE52F7E1A414295AE74 7446dd46d6b5a4bed08b1506ebc55c36da8c698644ab4e0ee5132f34f667573c 580c8d93-2ce6-11f1-9147-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42740 https://www.mdpi.com/2813-2475/5/2/16 1 3315a29f-2ce6-11f1-9147-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42739 Univerzitetni klinični center Ljubljana 0 0 0