Dr. Le Thi Ngoc Hang, from the Thoracic and Vascular Surgery Center at Tam Anh General Hospital, Ho Chi Minh City, reported that the patient had numerous blood vessel clusters scattered across her heel, the subcutaneous fat layer of her foot, and her third toe. A blood tumor, approximately 2,5 cm, was located on the outer side of her foot, with other lesions situated deep within the calf muscle, adjacent to the heel bone. These lesions were clustered and contained calcification points. This indicated low-flow vascular malformations, causing veins to dilate and coil into tortuous blood tumors under the skin.

MRI scan shows scattered blood tumors in the patient's sole. *Photo: Tam Anh General Hospital*.

The lesions caused pain and impacted her mobility and daily life, prompting Dr. Hang to recommend surgery for the symptomatic malformations. The surgical team meticulously dissected each vascular malformation cluster, which were deeply embedded and close to the foot's muscle and tendon structures, taking care to avoid damaging adjacent blood vessels and nerves.

According to Dr. Hang, precisely identifying the boundaries of each malformation cluster was crucial, as the lesions were interspersed within healthy tissue. Incomplete dissection would leave symptomatic malformations, while overly extensive intervention risked affecting the foot's mobility.

Ms. Huyen recovered well, experiencing minimal incision pain and a significant reduction in her previous pain symptoms. She was discharged after three days. Doctors advised her to limit pressure on the operated foot during the initial recovery period.

Dr. Hang (left) and the surgical team completely removed the blood tumor clusters from the patient. *Photo: Tam Anh General Hospital*.

Venous malformations are abnormalities that develop during the formation of the vascular system, potentially appearing on the arms, legs, head, face, or neck. When these lesions occur in the foot, they can cause pain, swelling, and impaired mobility. In some instances, blood clots may form within the malformed veins, leading to skin changes, ulcers, or bleeding.

Not all vascular malformations necessitate surgery. Treatment decisions are tailored by doctors based on the malformation's type, location, size, extent, and the patient's specific symptoms.

Patients should consult a vascular specialist if they notice a lump under the skin accompanied by swelling, pain, prominent blood vessels, or persistent skin discoloration.

Bao Anh

*Patient's name has been changed.