Venous Malformation
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A 30-year-old female military recruit presented to her medical “sick call” clinic with a cough and pleuritic chest pain. Physical examination demonstrated an approximately 3 cm soft tissue mass in the left supraclavicular region of the neck with palpable hard nodules. The remaining physical exam was unremarkable. The patient agreed to surgical excision and the final pathologic diagnosis was consistent with a venous malformation. A chest radiograph demonstrated multiple radiopacities overlying the left side of the neck. A subsequent contrast-enhanced computed tomography (CT) imaging study of the neck revealed a lobulated soft tissue mass with multiple coarse calcifications in the expected location of a level 4 lymph node. Magnetic resonance imaging (MRI) of the neck with and without contrast was performed to further characterize the neck mass. The 2.7 × 3.7 × 5.3 cm mass appeared isointense to muscle on T1 sequences, heterogeneously hyperintense on T2 sequences with diffuse enhancement on the post contrast images.

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