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Venous Malformations

Venous malformations are blue soft nodules, or large masses. Venous malformations can become darker blue when infants cry. When they are on the extremities, they can become larger when they are placed in a dependent position. Venous malformations can throb and become tender. Venous malformations can form calcifications in the lumen called phleboliths. Multiple venous malformations can be seen in the rare autosomal dominant condition called the blue rubber bleb nevus syndrome. Patients with blue rubber bleb nevus syndrome typically develop multiple red-blue soft and compressible papules scattered about the body. The lesions develop during early childhood and increase in number with age. The lesions are stable and do not resolve. The gastrointestinal tract may be involved, especially the small intestine and distal colon. Insidious gastrointestinal bleeding can result in iron deficiency anemia. Iron replacement is given for iron deficiency anemia and gastrointestinal lesions that are bleeding should be removed or cauterized by endoscopy.

Blue rubber bleb syndrome must be differentiated from another rare condition called multiple glomangiomas. Glomangiomas are firm and less compressible than blue rubber bleb lesions. Multiple glomangiomas occur as an autosomal dominant condition, however gastrointestinal involvement is not seen.