18-year-old patient with bluish spongy, enlarged tongue and lower lip on the right side and palpable thrombophleboliths in the area of the right cheek due to an extensive venous malformation (VM). A venous malformation can also be seen on the skin of the right cheek.
Outcome after sclerotherapy, tongue wedge resection, laser therapy, and lip correction surgery as well as repeat sclerotherapy treatments after a total of 7 procedures (including tracheostoma creation and closure) and 10 months’ total treatment duration.
Venous malformations (VM) located in the tongue and cheek/lip region may extend into the pharynx. A safe upper airway is required for treatment, for which a tracheostomy is sometimes required if there are extensive findings. Furthermore, implantation of a central venous catheter and prolonged postoperative or post-interventional intensive care may be required.
An extensive venous malformation may result in localized intravascular coagulation (LIC) with elevated D-dimers and low fibrinogen. This requires close hemostaseology/pediatric monitoring and therapy.
If left untreated, the venous malformation will lead to continued enlargement of the affected veins and complicate therapeutic access.
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