D. Buchbinder et al., PATIENTS EVALUATED FOR VENOUS DISEASE MAY HAVE OTHER PATHOLOGICAL CONDITIONS CONTRIBUTING TO SYMPTOMATOLOGY, The American journal of surgery, 166(2), 1993, pp. 211-215
Of the more than 200 patients recently evaluated for venous disease, 8
were diagnosed with lower extremity masses. Three patients were refer
red for superficial phlebitis and four for deep venous obstructive dis
ease. The eighth mass was found during work-up for varicose veins. Fiv
e masses were identified by palpation, and three were identified hy du
plex scan. All were confirmed by magnetic resonance imaging (MRI) or c
omputed tomography (CT). Of the eight masses, three were malignant: a
metastatic melanoma, a histiocytoma, and a myxoid liposarcoma. Nonmali
gnant masses included a hematoma, an inflammatory lesion, a hemangioma
, and an intramuscular lipoma. One patient presented with deep venous
thrombosis secondary to an occluded popliteal artery aneurysm compress
ing the popliteal vein. Thus, patients presenting with ostensible veno
us disease may have other pathologic conditions responsible for sympto
matology. Careful physical examination will reveal a mass, in a majori
ty of patients who have one. Duplex scanning will identify masses that
should be confirmed by MRI or CT. Definitive diagnosis should be made
by biopsy, due to the high possibility of malignancy.