Phlebolith-rich axillary venous malformation masquerading as lymphadenopathy of a multimodal diagnostic pitfall: A case report

BACKGROUND Venous malformations (VMs) are predominantly slow-flow vascular anomalies in which recurrent thrombosis can result in phlebolith formation.Deep axillary lesions may resemble lymphadenopathy, particularly when Doppler flow is minimal or undetectable in the interrogated component.CASE SUMMARY A phlebolith-rich axillary VM mimicking lymphadenopathy in a 39-year-old woman: Clustered calcifications with minimal Doppler flow prompted vascular reassessment before excision.CONCLUSION Clustered rounded calcifications, acoustic shadowing despite minimal regional Doppler flow, extension beyond a single nodal station and nondiagnostic bloodcontaining sampling should prompt consideration of a vascular anomaly.Targeted vascular imaging and assessment of venous connections may improve pre-intervention planning.