Multidisciplinary Approach to Congenital Vascular Malformations and Giant Nevi: Significance of Imaging in Pediatric Care

Abstract

Introduction: Congenital vascular malformations (CVMs) and giant congenital melanocytic nevi (GCMN) are rare pediatric conditions with significant functional, cosmetic, and psychosocial impact. Imaging plays a critical role in diagnosis, surgical planning, and long‑term management. Aim: To analyze how imaging findings influence surgical planning, risk stratification, and follow‑up strategies in children with CVMs and GCMN. Methods: A prospective observational study was conducted on 80 pediatric patients (50 CVMs, 30 GCMN). Clinical presentations, imaging modalities, and management approaches were systematically documented. Ultrasound, MRI, CT, angiography, and dermoscopy were employed based on pathology. Statistical analysis was performed using chi‑square testing to assess associations between age and presentation. Results: CVMs accounted for 62.5% of cases, with venous malformations being most common (17.5%). Giant nevi comprised 37.5%, predominantly truncal lesions. Infants formed the largest age group (37.5%). Cosmetic disfigurement was the most frequent presentation (28.7%), especially in giant nevi (50%), while feeding difficulties were exclusive to CVMs (24%). Ultrasound (37.5%) and MRI (31.2%) were the most utilized imaging modalities. Pediatric surgical intervention was the predominant management strategy (37.5%), followed by dermatological excision/laser and radiology‑guided procedures. Conclusion: CVMs present earlier and cause systemic complications, whereas giant nevi primarily lead to cosmetic and psychosocial issues. Imaging findings are central to diagnosis, surgical planning, and follow‑up, guiding multidisciplinary management. Advances in imaging and targeted therapies may further improve outcomes in these complex congenital conditions.

Keywords: Congenital Vascular Malformations (CVMs), Venous Malformation, Capillary Malformation (Port‑wine stain)