Use of intercostal nerve block for chest wall pain in a patient with CLOVES syndrome

Abstract

Congenital lipomatous overgrowth, vascular malformations, epidermal nevi and scoliosis/skeletal/spinal anomalies(CLOVES) syndrome is an extremely rare overgrowth syndrome characterized by complex vascular malformations. Management requires aninterdisciplinary approach including debulking operations for tissue overgrowth, embolization therapy for vascular malformations and management of chronic pain due tocongenital and recurrent vascular overgrowth and from scar tissue from surgical interventions. Here, we present a 35-year-old femalewith complex medical history due to CLOVES syndrome, with large vascular malformations on her chest, statuspost debulking/embolization previously and now with continued chronic nociceptive and neuropathic pain, largely due to the recurrent nature of vascular malformations, butnow finding some relief with fluoroscopy-guided intercostal nerve blocks which she never experienced before.