CLOVES syndrome with thoracic and central phlebectasia: increased risk of pulmonary embolism.
OBJECTIVE
CLOVES syndrome (congenital lipomatous overgrowth, vascular malformations, epidermal nevi, and skeletal/scoliosis and spinal abnormalities) is a rare, complex overgrowth syndrome with serious morbidity. In this communication we studied the presence of central and thoracic phlebectasia in patients with CLOVES syndrome and its clinical implications.


METHODS
We conducted a comprehensive search of our databases at Children's Hospital Boston over the last 10 years (1999-2008) for patients with CLOVES syndrome and central and thoracic phlebectasia. Medical records, clinical photographs, and imaging studies of varying modalities were reviewed.


RESULTS
Review of the clinical data and imaging studies of 12 patients with CLOVES syndrome documented the presence of central and thoracic phlebectasia in 11 patients. Two patients had serious perioperative pulmonary embolism, and 1 died.


CONCLUSIONS
Central and thoracic phlebectasia in patients with CLOVES syndrome is common and increases the risk of pulmonary embolism. Aggressive prophylactic measures should be considered before major interventions.
Division of Vascular and Interventional Radiology, Children's Hospital Boston and Harvard Medical School, Boston, Mass 02115, USA. ahmad.alomari@childrens.harvard.edu
Ahmad I
AI
Alomari
Patricia E
PE
Burrows
Edward Y
EY
Lee
Daniel J
DJ
Hedequist
John B
JB
Mulliken
Steven J
SJ
Fishman
D000015:Abnormalities, Multiple; D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D001900:Boston; D002648:Child; D002675:Child, Preschool; D019992:Databases as Topic; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007223:Infant; D008068:Lipomatosis / Q000151:congenital* / Q000473:pathology; D008297:Male; D009506:Nevus / Q000151:congenital* / Q000473:pathology; D010690:Phlebography; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012600:Scoliosis / Q000151:congenital* / Q000473:pathology; D012878:Skin Neoplasms / Q000151:congenital*; D013116:Spinal Cord / Q000002:abnormalities*; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications* / Q000473:pathology; D014680:Veins / Q000473:pathology*; D016306:Vena Cava Filters
D000925:Anticoagulants