BACKGROUND: Caliber-persistent labial artery (CPLA) is a vascular anomaly in which a primary artery penetrates the submucosa without caliber loss. It presents as an asymptomatic papular lesion, usually on the lower lip, which may be misdiagnosed as a malignant skin tumor and can cause severe bleeding during biopsy or surgery. Development of new high-resolution ultrasound equipment has improved its observation. AIM: This study was undertaken to assess the scope of ultrasound for the diagnosis of CPLA. METHODS: We report a case of a 65-year-old woman with a nodule involving the lower lip, initially misdiagnosed as a malignant skin tumor. Diagnosis was confirmed by high-resolution color Doppler ultrasound using a compact linear probe that generates frequencies of 7-15 MHz. RESULTS: The clinical presentation of the lesion, ultrasound technique, and sonographic findings are described. A current literature review of CPLA diagnosis was performed. Clinical and sonographic images are given as examples. CONCLUSIONS: High-resolution color Doppler ultrasound is a reliable noninvasive technique for CPLA diagnosis. It allows direct visualization of this vascular variant in real time without the use of an intravenous contrast agent. It may avoid surgical complications and help in the differential diagnosis. Newer high-resolution equipment allows a clear definition of the cutaneous and muscular layers, as well as the vascularity of the lips.
BACKGROUND: Caliber-persistent labial artery (CPLA) is a vascular anomaly in which a primary artery penetrates the submucosa without caliber loss. It presents as an asymptomatic papular lesion, usually on the lower lip, which may be misdiagnosed as a malignant skin tumor and can cause severe bleeding during biopsy or surgery. Development of new high-resolution ultrasound equipment has improved its observation. AIM: This study was undertaken to assess the scope of ultrasound for the diagnosis of CPLA. METHODS: We report a case of a 65-year-old woman with a nodule involving the lower lip, initially misdiagnosed as a malignant skin tumor. Diagnosis was confirmed by high-resolution color Doppler ultrasound using a compact linear probe that generates frequencies of 7-15 MHz. RESULTS: The clinical presentation of the lesion, ultrasound technique, and sonographic findings are described. A current literature review of CPLA diagnosis was performed. Clinical and sonographic images are given as examples. CONCLUSIONS: High-resolution color Doppler ultrasound is a reliable noninvasive technique for CPLA diagnosis. It allows direct visualization of this vascular variant in real time without the use of an intravenous contrast agent. It may avoid surgical complications and help in the differential diagnosis. Newer high-resolution equipment allows a clear definition of the cutaneous and muscular layers, as well as the vascularity of the lips.
Authors: José Antonio Llamas Carmona; Ángela Rivera Mercado; Miguel Lova Navarro; Elisabeth Gómez Moyano Journal: An Bras Dermatol Date: 2021-11-25 Impact factor: 1.896