Fifteen patients with subcutaneous cavernous (venous) malformations of the hand were reviewed. Six patients had a solitary lesion and 9 patients had multiple lesions. The vascular malformations were recognized at a mean age of 24 years (range, 16-40 years). Pain was the most common presenting symptom with radiographic calcifications noted in one-third of cases. Simple excision of symptomatic lesions was effective in alleviating pain; there were no recurrences at a minimum follow-up of 1 year.
Cavernous vascular malformations have been classified in the past as congenital and present at birth. However, Palmieri (Hand Clin, 1987) noted that most subcutaneous cavernous lesions in the hand presented after the first decade of life and were probably acquired in nature. The cases presented by Al-Qattan also support an acquired etiology for these lesions. Although factors associated with the development of subcutaneous venous malformations in the hand remain unknown, trauma may potentially lead to expansion.
Journal of Hand Surgery