A 12-year-old girl presented with a slightly painful swelling on the dorsum of the right foot. The patient reported a trauma three months before, involving the same region. Physical examination revealed a soft mass in the first intermetatarsal space, mildly painful upon compression. The skin around the swelling appeared normal (Figure 1). The patient underwent conventional radiographs which were negative and subsequently was referred for a magnetic resonance imaging (MRI) that showed a mass (with a 4.5 cm maximum diameter) containing dysplastic and tortuous blood vessels (Figure 2). No solid tissue was detectable within the mass. This imaging appearance, resembling a ‘bag of worms’ is characteristic of vascular malformations (VM), initially described in brain lesions (especially in arteriovenous malformations) (1). The lesion presents increased signal intensity on water sensitive sequences due to low-flow fluid, characteristic of a venous VM (V-VM).
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