Chemotherapy, such as sirolimus and alpelisib, inhibitors of the PI3K/AKT/mTOR pathway [22–24], has proven effective and safe in a variety of PIK3CA-related vascular anomalies, such as venous/lymphatic malformations (VM/LM) and PROS, by offsetting the progression of the malformations [25, 26]. This evidence concerns the gene AKT1 and lymphatic malformation.