Original ArticleChanges in Angiogenic Gene Expression in a Case of Expanded Capillary Malformation: Does an Expanded Capillary Malformation Grow?Kaji, Nobuyuki MD*; Nagase, Takashi MD*; Nagase, Miki MD†; Koshima, Isao MD*Author Information From the Departments of *Plastic and Reconstructive Surgery and †Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan. Received December 14, 2004, and accepted for publication, after revision, February 12, 2005. This work was supported by a Grant-In Aid for Scientific Research from the Japanese Ministry of Education, Science and Culture given to T. N. (15390537). This work was presented at the 12th Research Council Meeting of Japanese Society of Plastic and Reconstructive Surgery, held in Tokyo, Japan, on 9 October 2003. Reprints: Isao Koshima, MD, Department of Plastic and Reconstructive Surgery, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: firstname.lastname@example.org. Annals of Plastic Surgery: June 2005 - Volume 54 - Issue 6 - p 645-650 doi: 10.1097/01.sap.0000162458.88317.99 Buy Metrics AbstractIn Brief We examined a 59-year-old woman with a capillary malformation (CM) in her thigh, which was serially excised. Interestingly, the remnant CM after the first excision was enlarged at the time of the second excision. To investigate whether this phenomenon was caused by mere passive expansion or regrowth, the CM specimens of the first operation (nonexpanded) and the second operation (expanded) were examined. Expressions of angiogenic genes Tie2 and Angiopoietin-1 were up-regulated within the expanded CM compared with the nonexpanded lesion, suggesting angiogenesis in the expanded CM. Expression pattern of the endothelial marker von Willebrand factor and the capillary densities were unchanged after the excision, suggesting that angiogenesis seen in the expanded CM resulted in reorganization of vascular networks. We consider that our data support a hypothesis that the expanded lesion in this case was caused by regrowth, not a passive expansion, of the CM. Serial excision of a capillary malformation on a 59-year-old woman resulted in rapid re-enlargement of the lesion after the first excision. Upregulation of the angiogenic genes Tie2 and Angiopoietin-1 in the expanded lesion suggested that regrowth rather than passive expansion was the cause of re-enlargement. © 2005 Lippincott Williams & Wilkins, Inc.