Case Presentation: A female infant was transferred to the neonatal intensive care unit from the neonatal nursery for evaluation on the day of delivery. She was the product of an elective cesar-ean section at 39 weeks gestation following a pregnancy complicated by maternal anemia, persistent left ovarian cyst, and obesity. She was large for gestational age (4095 g) with APGAR scores of 8 and 9 at 1 and 5 minutes, respectively. Routine prenatal ultrasonography had not revealed any abnormality but the infant was noted to have a large vascular malformation covering the entire right upper extremity (Figure 1), extending from the supraclavicular area to the fingertips. The lesion was deep purple in color with scattered petechiae. The infant was noted to hold the arm in a tightly flexed position. The infant's hand circumference measured 15.9 cm, the forearm at the elbow crease measured 16.8 cm, and the proximal upper arm measured 15.2 cm.
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