gms | German Medical Science

Objectives/Interrogation: Fibro-adipose vascular anomaly (FAVA) is a distinctive malformation due to its radiological and histopathological characteristics. Is a mesenquimal malformation that presents in focal and difuse form, whose changes include muscle adipose infiltration, phlebectasia, venous anomalies and malformation of the subcutaneous lymphatic system that tend to surround the neural structures. The aim of this study is to describe a clinical case in a 22-year-old woman with a diagnosis of a fibroadipose vascular anomaly in the forearm.

Methods: Retrospective evaluation of a 22-year-old female, with no morbid background, that presented on consultation with approximately 3 years of evolution of volume increase in medial region of left forearm, of progressive growth and oscillating size and which is associated with progressive lack of force of the limb and digital flexion deficit. Studied with sonogram and MRI with confirmed a vascular tumor (hemangioma) of the forearm infiltrating the carpal tunnel and the flexor muscles at the forearm.

Results and Conclusions: Multidisciplinary evaluation of the patient and images with the radiologists concluded that it was a fibro adipose vascular anomaly out of the reach for sclerotherapy. She went under surgery for tumor resection. Surgery findings included an extensive adipose tumor that infiltrated all the flexor muscles at the forearm deep to the pronator muscle and surrounding the median nerve. The hole of the tumor was excised.

Good post operative evolution with full wrist and finger motion and transitory median nerve neuropraxia that spontaneously recovered within 3 months.

From the clinical point of view it is important to recognize the FAVA since it may require a different treatment to the classic vascular malformations, due to the abundant fibro-adipose formation that makes the sclero-therapy of little or no utility, making surgical resection necessary.