Needle trauma as a trigger for clinical manifestation of a pre-existing venous malformation: a case report

Vascular anomalies include a broad spectrum of benign congenital lesions with varying clinical presentations. Historically, terms such as 'cavernous hemangioma' have been used imprecisely. Recent consensus supports classifying these lesions as vascular malformations rather than tumors. We report a case of a 58-year-old man with a venous malformation of the arm that became clinically evident at the site of venous blood sampling 10 years earlier. Preoperative computed tomography scan showed a well-circumscribed, vascularized mass in the antecubital fossa. Excision was performed for progressive enlargement, recurrent thrombophlebitis. Histopathology confirmed a low-flow venous malformation consistent with current vascular anomaly classifications. Although venous malformations are congenital lesions, the temporal association with venous puncture suggests that local trauma may have induced hemorrhage or thrombosis, acting as a trigger for lesion enlargement and clinical manifestation. This case highlights the possible role of local trauma in triggering the clinical manifestation and progression of a previously silent venous malformation.