Venous Malformations in Children: When to Operate?

Abstract

Background: Congenital venous malformations in children are common and their management can be challenging. Injection sclerotherapy and surgery are the main treatment modalities. Patients and methods: The charts of 10 children with venous malformations who were treated by surgical excision of their lesions were reviewed. Results: There were 6 males and 4 females with a mean age of 3.6 years. Lesions were located in the neck (n=3), upper extremity (n=3), trunk (n=2) and lower extremity (n=2). The main presentation was a growing mass lesion. Pain was reported in one patient and a sense of heaviness was reported in another patient. All lesions were of the discrete spongy type and their mean size was 5.8 cm. Clinical examination and MRI were used for diagnosis. Complete surgical excision was achieved in all cases with a mean operative time of 80 minutes. The diagnosis of venous malformations was confirmed postoperatively by histopathologic examination. There was no recurrences during a mean follow up period of 2.3 months. All patients had satisfactory functional and cosmetic outcomes apart from two patients with wound related complications. Conclusion: Surgical excision of venous malformations can be safe provided certain selection criteria are employed.