venous malformations
Last reviewed 01/2018
These are congenital, non-proliferating, slow-flow vascular malformations composed of anomalous ectatic venous channels. They are caused by aberrant vascular development (1).
These lesions may not always be obvious at birth and may appear later in life (2). Lesions can occur sporadically or they may be inherited in an autosomal dominant manner (1).
They are considered to be the most common vascular anomalies (2).
They usually appear as soft, compressible blue masses that enlarge when the affected area is in a dependent position or with physical activity. They can occur anywhere and may be either localised or more extensive, particularly the head and neck lesions.
Extension into surrounding structures is common with these lesions (1).
Lesions in the head and neck area and mucosal surfaces can cause significant cosmetic defects, recurrent bleeding, airway obstruction, and interfere with speech and dentition.
Phlebolith formation is possible. Localised intravascular coagulation in the venous malformations may lead to episodes of thrombosis and/or bleeding. This is usually seen in adolescence or early adulthood (1).
Extremity lesions are usually localised or segmental.
Extensive pure venous malformations in the extremities may extend into the muscles and joints and can be associated with diminished girth or slight hypertrophy of the affected limb.
Pain is a common complaint in extremity venous malformations (1).
Deeper lesions without superficial involvement may remain unnoticed until symptoms cause the patient to seek help (1).
Glomuvenous malformation (glomangioma/venous malformation with glomus cells) is a rare type of venous malformation that is clinically and histologically distinct from the typical venous malformations (1).
Diagnosis is assisted by MRI.
Treatment involves sclerotherapy, surgical excision, or a combination of both (1).
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