High-resolution color Doppler ultrasound of a caliber-persistent artery of the lip, a simulator variant of dermatologic disease: case report and sonographic findings.

Background  Caliber-persistent labial artery (CPLA) is a vascular anomaly in which a primary artery penetrates the submucosa without caliber loss. It presents as an asymptomatic papular lesion, usually on the lower lip, which may be misdiagnosed as a malignant skin tumor and can cause severe bleeding during biopsy or surgery. Development of new high-resolution ultrasound equipment has improved its observation. Aim  This study was undertaken to assess the scope of ultrasound for the diagnosis of CPLA. Methods  We report a case of a 65-year-old woman with a nodule involving the lower lip, initially misdiagnosed as a malignant skin tumor. Diagnosis was confirmed by high-resolution color Doppler ultrasound using a compact linear probe that generates frequencies of 7–15 MHz. Results  The clinical presentation of the lesion, ultrasound technique, and sonographic findings are described. A current literature review of CPLA diagnosis was performed. Clinical and sonographic images are given as examples. Conclusions  High-resolution color Doppler ultrasound is a reliable noninvasive technique for CPLA diagnosis. It allows direct visualization of this vascular variant in real time without the use of an intravenous contrast agent. It may avoid surgical complications and help in the differential diagnosis. Newer high-resolution equipment allows a clear definition of the cutaneous and muscular layers, as well as the vascularity of the lips.