Venous Varix — ORE Part 1 MCQ

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EasyOral PathologyVenous VarixORE Part 1

A 28-year-old man presents with a painless dark blue/purple nodule on his lower lip. It is compressible and refills slowly on release of pressure. It has been present for several years and has not changed in size. What is the most likely diagnosis?

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Correct answer: C — Venous varix (venous lake)

The diagnosis is venous varix (venous lake). The key discriminating features are compressibility and slow refill on decompression—pathognomonic findings for a low-flow venous lesion. The dark blue/purple color, painlessness, lip location, and long-term stability without change further support this diagnosis. Venous lakes are benign vascular tumors; although typically seen in older adults, they can occur in younger individuals. Melanoma would change over years and lack compressibility. Amalgam tattoo is grey-black and non-compressible. Haemangiomas are usually congenital/early-onset and present differently. Kaposi sarcoma requires immunocompromise and typically presents with progressive or multiple lesions.

Reference: Lee JS, Mun J-H. Dermoscopy of venous lake on the lips: a comparative study with labial melanotic macule. PLoS One. 2018 Oct 31;13(10):e0206768. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209377/; Trafalski M, Kozakiewicz M, Jurczyszyn K. Application of Fractal Dimension and Texture Analysis to Evaluate the Effectiveness of Treatment of a Venous Lake in the Oral Mucosa Using a 980 nm Diode Laser. Materials. 2021 Jul 25;14(15):4140. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347063/