Fibro-adipose vascular anomaly (FAVA) is a new entity characterized by fibro-adipose infiltration of muscle, pain, and contracture. The main differential diagnosis includes venous malformation and intramuscular hemangioma. Early treatment and physical therapy are of paramount importance to prevent severe contractures, muscle fibrosis, and limb atrophy. We present a case report of a 24-year-old female patient with FAVA in the volar aspect of left arm, presented with limitation to pronation and supination and pain. The patient was operated in 2017 in our center, performing a total resection of the mass and 2-year follow-up. We describe the criteria that we performed to diagnose the left forearm FAVA in this patient, based on the history; the magnetic resonance imaging, which demonstrated muscle replaced by heterogeneous soft tissue, intramuscular phlebolit, and dilated vessels; and histological images that showed a vascular proliferation associated with adipocytes and dense fibrous tissue replacing and infiltrating the skeletal muscle. En bloc resection of the mass was performed successfully, and it gave excellent results with recovery of limitation and improvement of pain and swelling that were maintained at 2-year follow-up. Surgery is a reliable and curative option in FAVA and could be the only one for long-term control of this entity.
Level of evidence: Level V, therapeutic; diagnostic study.
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The authors declare that they have no conflict of interest.
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López, S., Ibarra, A., Baselga, E. et al. Fibro-adipose vascular malformation (FAVA) in forearm: a successful surgical approach and literature review. Eur J Plast Surg (2020) doi:10.1007/s00238-019-01620-z
- Vascular anomaly
- Surgical treatment