Osseous Metaplasia Mimicking Long Bone in Intramuscular Vascular Malformation

We describe a case of intramuscular vascular malformation with extensive ossification within the posterior compartment muscles of leg which grossly mimicked long bone leading to equinus deformity of foot. Phleboliths and calcifications are characteristic of vascular malformations, while massive ossification is rare. To our knowledge, no extensive ossified vascular malformation within the leg muscle has been reported. Intramuscular vascular lesions occur with an incidence of 0.8%, most frequent in upper and lower extremities. Most are venous malformations. The diagnosis is rarely made before surgery and requires a definitive histological analysis, as there are no pathognomonic clinical or radiographic findings, especially with extensive ossification. Spontaneous regression does not occur, and excision of lesion is due to aesthetic and functional disturbances.