Cavernous angiomas are common in the upper body and viscera but saphenous vein cavernous angiomas have not been previously described in the literature. We present a case of a rare congenital vascular malformation of the lower extremity masquerading as an aneurysm in a 4-year-old girl who presented with an asymptomatic right lower leg mass. Ultrasound was concerning for saphenous venous aneurysm and MRI was confirmatory. Operative exploration identified a vascular mass without evidence of an aneurysm; cavernous angioma was confirmed on pathologic examination. Although infantile vascular lesions are common, imaging diagnosis of venous aneurysm – an unusual asymptomatic clinical entity – should raise concerns about possible rare entities or diagnostic alternatives.
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