Presentation
Progressive swelling in sole of left foot for 6 months along with pain exacerbated on exercise. Soft swelling with local paresthesia was found on examination.
Patient Data
Ill-defined soft tissue swelling of sole of foot with calcified foci.
Longitudional scan through sole of right foot shows multiple dilated and tortuous vascular channels with sluggish flow on color Doppler which is enhanced on compression. A phlebolith could also be identified (arrow).
Intramuscular location of the lesion, deep to plantar aponeurosis. Involvement of flexor digitorum brevis, abductor halluces and quadratus plantae muscles with subcutaneous extension. Multiple fluid-fluid levels seen due to stagnant flow. Coronal STIR images showing intramuscular lesion with extension along tendon sheaths and into subcutaneous tissue. Mild heterogenous post-contrast enhancement of the lesion.
Case Discussion
Venous malformations are postcapillary dilated venous spaces characterized by stagnant flow, lack of normal venous valves, and absence of arteriovenous shunting. Venous malformations are the most common peripheral vascular malformation 1.
Common locations are head and neck (40%), trunk (20%), and extremities (40%) 2.
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