CLOVES syndrome CLOVES syndrome is an extremely rare overgrowth syndrome with complex vascular anomalies . CLOVES syndrome affects people with various symptoms, ranging from mild fatty soft-tissue tumors to vascular malformations encompassing the spine or internal organs . CLOVES syndrome is closely linked to other overgrowth disorders like proteus syndrome , Klippel–Trénaunay syndrome , Sturge–Weber syndrome , and hemihypertrophy , to name a few. It can also cause fat to move to the back, and many cases undescended testicles . 'CLOVES' is an acronym for: C is for congenital . L is for lipomatous, which means pertaining to or resembling a benign tumor made up of mature fat cells . Most CLOVES patients present with a soft fatty mass at birth, often visible on one or both sides of the back, legs and/or abdomen. O is for overgrowth, because there is an abnormal increase in the size of the body or a body part that is often noted at birth. Patients with CLOVES may have affected areas of their bodies that grow faster than in other people . Overgrowth of extremities is seen, with large wide hands or feet, large fingers or toes, wide space between fingers, and asymmetry of body parts . V is for vascular malformations, which are blood vessel abnormalies. Patients with CLOVES have different venous, capillary, and lymphatic channels - typically capillary, venous and lymphatic malformations are known as "slow flow" lesions. Some patients with CLOVES have combined lesions and some have aggressive vascular malformation known as arteriovenous malformations . The effect of a vascular malformation varies per patient based on the type, size, and location of the malformation, and symptoms can vary. E is for Epidermal naevi , which are sharply-circumscribed chronic lesions of the skin, and benign. These are often flesh-colored, raised or warty. S is for Spinal/Skeletal Anomalies or scoliosis . Some patients with CLOVES have tethered spinal cord , vascular malformations in or around their spines, and other spinal differences. High-flow aggressive spinal lesions can cause serious neurological deficits/paralysis. The syndrome was first recognised by Saap and colleagues who recognised the spectrum of symptoms from a set of seven patients. In this initial description the syndrome is named CLOVE syndrome. It is believed that the first description of a case of CLOVES syndrome was written by Hermann Friedberg , a German physician, in 1867.Causes s in the PIK3CA have been identified as a cause of CLOVES syndrome. PIK3CA is a protein involved in the PI3K-AKT signalling pathway . Mutations in other parts of this pathway cause other overgrowth syndromes including Proteus syndrome and hemimegaencephaly .
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