VERRUCOUS MALFORMATIONS AS A RARE CASE IN THE GROUP OF VASCULAR ANOMALIES WITH SLOW BLOOD FLOW IN CHILDREN
Date Issued
2025-04-04
Author(s)
Kamiloski, Marijan
Lumani Bakiji, Njomza
Racaj, Anila
DOI
https://icrc.mld.mk/agenda/
Abstract
Verrucous venous malformations belong to the group of vascular anomalies. The International
Society for the Study of Vascular Anomalies (ISSVA) classifies these changes into two major
groups: vascular tumors and vascular malformations. The vascular malformations group includes
lymphatic malformations, venous malformations, and their combinations (malformations with
slow blood flow), as well as arteriovenous malformations (malformations with fast blood flow).
Verrucous venous malformations (VVM) are a rare congenital vascular anomaly first described by
Helwig in 1967. They are characterized by varying degrees of hyperkeratosis of the skin and
subcutaneous tissue. Clinically, they manifest as dark red solitary or multiple hyperkeratotic
plaques, most commonly localized on the extremities. Treatment is combined and includes
surgical intervention, electrocoagulation, laser therapy, topical agents, and systemic medications.
Materials and Methods: Between 2019 and 2024, two children with suspected verrucous venous
malformations were admitted to the Public Healthcare Institution – University Clinic for Pediatric
Surgery. The lesions were unilaterally located on the lower extremities. The gender distribution
was 1:1 (male to female), with an average age of 10 years. The changes had been present since
birth. There was no positive family history in either patient. Clinically, one of the patients
presented with inflammation of the lesion, accompanied by pain and serous secretion.
Results: Following appropriate preoperative preparation, both patients underwent surgical
excision and autologous skin transplantation. The postoperative course was uneventful.
Histopathological examination confirmed the diagnosis. After excision, electrocoagulation was
applied to residual lesions. A reduction of approximately 90% in lesion size was recorded.
Conclusion: Verrucous venous malformations are a rare type of malformation within the group of
vascular anomalies, requiring a multidisciplinary treatment approach.
Society for the Study of Vascular Anomalies (ISSVA) classifies these changes into two major
groups: vascular tumors and vascular malformations. The vascular malformations group includes
lymphatic malformations, venous malformations, and their combinations (malformations with
slow blood flow), as well as arteriovenous malformations (malformations with fast blood flow).
Verrucous venous malformations (VVM) are a rare congenital vascular anomaly first described by
Helwig in 1967. They are characterized by varying degrees of hyperkeratosis of the skin and
subcutaneous tissue. Clinically, they manifest as dark red solitary or multiple hyperkeratotic
plaques, most commonly localized on the extremities. Treatment is combined and includes
surgical intervention, electrocoagulation, laser therapy, topical agents, and systemic medications.
Materials and Methods: Between 2019 and 2024, two children with suspected verrucous venous
malformations were admitted to the Public Healthcare Institution – University Clinic for Pediatric
Surgery. The lesions were unilaterally located on the lower extremities. The gender distribution
was 1:1 (male to female), with an average age of 10 years. The changes had been present since
birth. There was no positive family history in either patient. Clinically, one of the patients
presented with inflammation of the lesion, accompanied by pain and serous secretion.
Results: Following appropriate preoperative preparation, both patients underwent surgical
excision and autologous skin transplantation. The postoperative course was uneventful.
Histopathological examination confirmed the diagnosis. After excision, electrocoagulation was
applied to residual lesions. A reduction of approximately 90% in lesion size was recorded.
Conclusion: Verrucous venous malformations are a rare type of malformation within the group of
vascular anomalies, requiring a multidisciplinary treatment approach.