Arterio-venous malformation masquerading as lymphangioma circumscriptum managed with embolization

Lymphangioma circumscriptum and peripheral arteriovenous malformations (AVM) are both conditions that commonly present during adolescence as an enlarging lesion with occasional oozing and bleeding. Lymphangioma circumscriptum though is unlikely to cause any serious life-threatening complication whereas an expanding AVM can lead to complications like high output cardiac failure. Furthermore, while lymphangioma circumscriptum can be treated easily with sclerotherapy or excision, AVM requires a multi-modality treatment including a combination of endovascular approaches, surgery, and sclerotherapy. Here, we discuss the case of a boy who presented to us with such lesions over the left inguinal region of two months duration. Clinically and dermoscopically, the lesions were indistinguishable from that of lymphangioma circumscriptum but histopathology and radiology revealed an underlying AVM from the circumflex femoral vessels. The patient was subsequently managed with glue embolization.