Venous malformations

Venous malformations are birthmarks made up of superficial or deep veins that are abnormally formed or enlarged. These common vascular lesions grow slowly and steadily as the child grows. Although the skin or organs may be involved, these malformations are most often found in the cheek, jaw, tongue and lips.

Venous malformations can range in color from the bluish hue of a deep malformed vein to the maroon-ish color of a more superficial one. They may also present as a colorless mass. Venous malformations are soft to the touch and lighten in color when compressed, due to the release of blood. The color becomes more intense when the child is lying down as the lesion fills with blood.

The cause of venous malformations is unknown.

Venous malformations can be confirmed through medical history and physical exam. The extent of the malformation is determined through MRI or CT scans.

The treatment of venous malformations varies according to the depth, location and extent of the lesion. Small lesions are observed over time and often do not require any treatment. Compression garments can be used to control swelling or pain in lesions found in the arms or legs. Several options exist for more serious lesions. These include:

• Sclerotherapy: A scarring agent is injected into the vein in order to close it off to blood flow.
• Laser therapy: A laser is used to shut off the vein from flood flow.
• Embolization: This highly specialized procedure involves the injection of small particles into the blood vessel to stop the flow of blood.
• Surgical excision: Venous malformations are difficult to remove surgically. But, when necessary, extensive lesions can be partially removed. The remaining lesion may be treated with another form of therapy listed above.

All of these procedures have risks that should be discussed with the physician. These risks must be weighed against the emotional and physical wellbeing of the child.