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Acta Paediatr. 2015 Nov;104(11):1109-16. doi: 10.1111/apa.13076. Epub 2015 Jul 28.

An interdisciplinary specialist team leads to improved diagnostics and treatment for paediatric patients with vascular anomalies.

Author information

1
Department of Paediatric Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
2
Department of Radiology, HUS Medical Imaging Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
3
Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
4
Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
5
Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
6
The College of Medicine, Qatar University, Doha, Qatar.

Abstract

AIM:

Patients with vascular anomalies are often misdiagnosed, leading to delayed or improper treatment. The aim of this study was to evaluate the impact of an interdisciplinary team on the diagnosis and treatment of paediatric patients with vascular anomalies.

METHODS:

We reviewed the paediatric patients evaluated by our interdisciplinary team between 2002 and 2012, analysing the referral diagnosis, final diagnosis, patient age, sex, clinical history, laboratory tests, imaging studies and treatments.

RESULTS:

Of the 480 patients who were evaluated, 435 (90.6%) had a vascular anomaly: 30.7% of all patients had a tumour and 55.2% had a malformation. Haemangiomas comprised 93.2% of all tumours, while malformations included capillary (9.8%), lymphatic (30.1%), venous (36.8%), arteriovenous (3.8%) and combined slow-flow (7.9%) malformations. Tumours were initially diagnosed correctly in 89.2% of the patients, but only 38.0% of the malformations were diagnosed correctly. Improper treatment was given to 1.4%, due to incorrect diagnoses.

CONCLUSION:

This study showed that haemangiomas were likely to be diagnosed correctly, but other tumours and vascular malformations were likely to be misdiagnosed. Misdiagnosis seldom led to improper treatment, but probably led to delayed treatment in many cases. The interdisciplinary approach led to improved diagnostics and treatment.

KEYWORDS:

Diagnostics; Haemangiomas; Interdisciplinary; Paediatric; Vascular anomalies

PMID:
26096329
DOI:
10.1111/apa.13076
[Indexed for MEDLINE]

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