Uncommon, unrelenting, and under recognized – This is fibro-adipose vascular anomaly

Fibro-adipose vascular anomaly (FAVA) is a rare, benign but clinically aggressive vascular malformation characterized by fibro-fatty replacement of muscle, venous ectasia, and thrombosis. It often presents with pain, swelling, and functional limitation, frequently mimicking more common vascular malformations or soft-tissue tumors. We present three cases of FAVA involving the thigh and leg musculature, highlighting the clinical presentation, imaging spectrum, and management implications. Awareness of this entity and recognition of its imaging hallmarks are crucial to prevent misdiagnosis and guide appropriate treatment.