Differential diagnosis with other forms, T or ET forms, as well as other kinds of vascular malformation, VM. LM, VLM, or AVM, is mandatory, in view of their different behavior with different clinical impact. This is particularly important for the ET form of various vascular malformations whose behavior is totally unpredictable. The ET form retains the original evolutional ability of mesenchymal cells, in contrast to the T form, so that it can grow when the condition/stimulation should meet (e.g., trauma, surgery, pregnancy, hormone therapy).10 Regarding the VM of the lower extremity, precise differential diagnosis of other conditions such as LM or AVM is extremely important, because the treatment strategy is substantially different.6,27 Besides, initial differential diagnosis for VM, like any vascular malformation, should start from the infantile (neonatal) hemangioma which also belongs to the vascular anomaly together with the vascular malformation. Hemangioma is a true vascular tumor and not a vascular malformation, possessing distinctively different pathophysiology, anatomico-histology, and clinical behavior.1,31 [Q11: E] The clinical significanceofcapillarymalformationisnotunderstoodproperlyyet,butitshouldbeincluded in the evaluation of any vascular malformation although the modified Hamburg classification did not include it in the classification of various CVMs, due to the lack of clinical significance for the vascular surgeon.32

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