Background:Vascular anomalies are vascular tumors and congenital malformation s that rarely involve the pancreas.Diagnosis and management of these lesions is complex.Methods:An institutional review board-approved retrospective databas e and record review from 1994 through 2004 at a quaternary referral center for v ascular anomalies was conducted.Results:Of 5051 patients with a vascular anoma ly,6 had a lesion involving the pancreas.All patients were younger than 3 year s.There were three tumors(two infantile hemangiomas and one Kaposiform hemangi oendothelioma)and three malformations(two lymphatic and one venous).The refer ring diagnoses were correct for 4 patients.All anomalies were diagnosed with a combination of cross-sectional imaging and angiography.Five patients received medical therapy including two malformation patients who were initially treated w ith antiangiogenic drugs.Two patients with lymphatic malformations underwent op erative intervention.One infantile hemangioma was treated with percutaneous bil iary drainage for obstructive jaundice.Conclusion:Complex pancreatic vascular anomalies are rare.Vascular tumors are generally amenable to treatment with ant iangiogenic medications.Operative resection is reserved for refractory cases or complications.Symptomatic vascular malformations are treated exclusively by su rgery.Evaluation and management of these lesions is complex and may benefit fro m coordinated interdisciplinary care. Background: Vascular anomalies are vascular tumors and congenital malformation s that rarely involve the pancreas. Diagnostic and management of these lesions is complex. Methods: institutional review board-approved retrospective databas e and record review from 1994 through 2004 at a quaternary referral center for Results: Of 5051 patients with a vascular anoma ly, 6 had a lesion involving the pancreas. All patients were younger than 3 year s. There were three tumors (two infantile hemangiomas and one Kaposiform hemangi oendothelioma) and three Malformations (two lymphatic and one venous). The refer ring diagnoses were correct for 4 patients. All anomalies were diagnosed with a combination of cross-sectional imaging and angiography. Fives patients received medical therapy including two malformation patients who were initially treated w ith antiangiogenic drugs.Two patients with lymphatic malformations underwent op erative intervention. One infantile hemangioma was t reated with percutaneous bil iary drainage for obstructive jaundice.Conclusion: Complex pancreatic vascular anomalies are rare. Vascular tumors are generally amenable to treatment with ant iangiogenic medications. Optimentary resection is reserved for refractory cases or complications. Symptomatic vascular malformations are treated exclusively by su rgery . Evaluation and management of these lesions is complex and may benefit fro m coordinated interdisciplinary care.