Purpose or Case Report: Glomovenous malformations (GVM) are rare, low-flow vascular malformations arising from glomus body components. They often present as bluish, compressible nodules or plaques, usually located in the extremities. Because they are infrequent and may mimic more common venous malformations, they are frequently underrecognized.
Methods & Materials: A retrospective review of reports over the last 10 years identified 19 patients with the term “glomovenous malformation” in imaging reports. Three radiologists with experience in pediatric soft-tissue ultrasound independently reviewed the studies. Cases with agreement between at least two reviewers and final clinical diagnosis of GVM were included. After excluding adult patients, ten pediatric cases remained. All underwent color Doppler ultrasound and three patients MRI.
Our group had seven males and three females, aged 3–17 years. In eight cases, the clinical suspicion was of a vascular or glomovenous malformation, while two were referred with another presumed diagnosis. 50% of the patients presented multiple lesions, four limited to a single body segment and one with multisegmental involvement. Lesions were located predominantly in the extremities (90%).
On ultrasound, GVMs appeared as heterogeneous, multiloculated pseudonodular structures with confluent loculations. They demonstrated a hypoechoic stroma traversed by fine echogenic septa and tubular structures, partially compressible under gentle pressure. The lesions were surrounded by subcutaneous fat, which in several cases exhibited mildly increased echogenicity. Confluent areas measured between 10 and 30 mm in greatest dimension.
Color Doppler evaluation revealed predominantly venous intralesional flow, with occasional fine, low-resistance arterial vessels identified in approximately 90% of cases. Overall vascular density was low on all lesions. MRI, confirmed low-flow vascular lesions with venous enhancement patterns and no arterial components, with high T2 signal intensity.
Results:
Conclusions: Glomovenous malformations are an uncommon but distinctive subset of venous malformations. Recognizing their characteristic appearance on ultrasound and Doppler is key to diagnosis. Color Doppler ultrasound provides both morphological and hemodynamic information, facilitating early detection, reducing the need for invasive procedures, and guiding appropriate treatment planning.