Soft tissue venous malformation - thorax

Case contributed by Mohamed Abdalla
Diagnosis almost certain

Presentation

Long-term left chest wall swelling.

Patient Data

Age: Young adult
Gender: Male

Plain radiograph

x-ray

Left chest wall soft tissue prominence containing multiple round punctate calcifications (phleboliths).

MRI chest with IV contrast

mri

Left chest wall mass showing serpiginous altered signal, predominantly hyperintense on T2 & STIR WIs and hypointense on T1 WIs, with contrast uptake and punctate foci of low signal on all pulse sequences in keeping with calcification (phleboliths). The lesion shows no aggressive behavior.

Case Discussion

The differential diagnosis of this case is plexiform neurofibroma, but the presence of phleboliths is highly suggestive of venous malformation.

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