Prepared by Larry A. Sargent, MD, Professor and Chairman, Edward A. Abell, MD, Resident, Lesley K. Wong, MD, Associate Professor, and Leslie Turner, ACNP-C, Research Assistant, Department of Plastic and Reconstructive Surgery, Hayes Hand Center, University of Tennessee College of Medicine-Chattanooga Unit

A boy weighing 3.39 kg (7.47 lb) was delivered by elective cesarean section at 35 weeks of gestational age. Transabdominal ultrasound at 25 weeks gestation had shown an enlarged left leg. Physical examination revealed that his height and weight were in the 37th percentile. The left leg was significantly enlarged, with areas of port-wine stains and varicosities (Figure 1). The right foot had a simple syndactyly of the second, third, and fourth toes, without vascular malformation. Plain film radiographs displayed normal femur lengths bilaterally; however, the left tibia was 14% longer than the right tibia (Figure 2).

What’s Your Diagnosis?
Sturge-Weber syndrome 

Arteriovenous malformation

Klippel-Trénaunay syndrome

Maffucci’s syndrome