PATIENTS EVALUATED FOR VENOUS DISEASE MAY HAVE OTHER PATHOLOGICAL CONDITIONS CONTRIBUTING TO SYMPTOMATOLOGY

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.