School of Podiatric Medicine - Student Research

Document Type

Poster

Publication Date

9-26-2026

Abstract

Introduction: Arteriovenous malformations (AVMs) are abnormal connections between artery and vein, lacking an intervening capillary bed. Although AVMs are mostly congenital, they are rare in the pediatric population, and their presentation in the foot is particularly uncommon, presenting with broad, nonspecific findings such as swelling, discoloration, or non-painful/painful masses. Their variability delay recognition and management, which can cause their progression to lead to ulceration/bleeding, functional impairment, and even amputations.

Aim: To present a case and investigate the reported occurrences and clinical characteristics of AVMs in the pediatric foot.

Methods/Case Presentation:

Review: A PubMed and Google Scholar search identified pediatric foot AVM cases. PubMed yielded 244 articles; after applying full-text, English-language, and age < 18 filters, 31 were screened and 5 met inclusion criteria. Google Scholar identified 35 articles with “foot” and “arteriovenous malformation” in the title, of which 5 met inclusion.

Case: A 13-year-old Hispanic female presented with a progressively enlarging, mildly sore mass on the left 1st MTPJ. Examination revealed a 1x1cm mobile, non-pulsatile mass medial to the extensor hallucis longus tendon, without skin adherence or signs of infection. Bluish discoloration of the overlying skin was noted. Radiographs showed no osseous involvement, and ganglion cyst was suspected. Four months later, ultrasound demonstrated a multilobulated cystic lesion.

Results

Review: Ten studies include 8 case reports, 1 case series, and 1 retrospective cohort. Patients ranged from 3 months to 17 years, with isolated lesions to extensive foot involvement. Angiography, Doppler, and MRI/MRA were the predominant diagnostic modalities. Treatment included embolization, sclerotherapy, surgical resection, and amputation. Outcomes were generally favorable.

Case: The patient underwent surgical excision approximately eight months after her initial presentation with multiple venous structures feeding the lesion. Histopathologic examination demonstrated an AVM. She healed uneventfully.

Conclusions: Few reported cases highlight gaps in understanding pediatric foot AVMs. Bluish skin discoloration may be a clue to underlying vascular etiology.

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