Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10994
Peer-review started: April 28, 2021
First decision: May 23, 2021
Revised: May 29, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: December 16, 2021
Processing time: 225 Days and 17.3 Hours
Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder. A detailed prenatal ultrasound examination plays an important role in the diagnosis of KTS and the subsequent counseling and follow-up of the patient.
A 25-year-old woman attended our department for a regular examination. The whole of the right lower extremity and right buttock were observed to be markedly thicker compared to the left one at 18 wk of gestation. However, the lengths of the right femur, tibia and fibula were in the normal range. No marked edema and fluid/cystic spaces were detected in the lower limbs. There were no other organ abnormalities. The vasculature in the right limb was visibly dilated, with much higher intensive blood flow signals. No congenital embryonic veins were visible in both limbs. The right lower limb exhibited much more hypertrophy compared to the left limb two weeks later. Amniocentesis and genetic tests showed normal results with 46 XX. Despite the normal karyotype, the family opted to terminate the pregnancy. The post-mortem examination confirmed asymmetric hypertrophy of the right limb in the fetus and revealed a large area of marked dark-purple superficial capillary malformations occupying the skin of the right lower extremity. The enlargement of veins and soft tissue hypertrophy were also seen on postnatal X-ray and Magnetic Resonance Imaging. Autopsy revealed severe congestion in the right lower limb. A final diagnosis of KTS was made.
KTS may be diagnosed prenatally based on the typical features observed during ultrasound examination.
Core Tip: Klippel–Trenaunay syndrome (KTS) is a rare congenital disorder. The prenatal ultrasound features include hypertrophy of one extremity, a difference between the length of the bones of the extremities, multiple cystic lesions of the extremities or internal organs, increasing blood flow signals and dilated veins or persistence of the embryonic veins. KTS may be diagnosed based on these typical characteristics in utero.