PIK3CA and Venous malformation: These malformations can be associated with hemorrhage, infections, thrombosis, pulmonary embolism, chronic pain, fatigue, functional impairments, disabilities and disseminated intravascular coagulation.1 Genetically, venous malformations are mainly due to gain-of-function mutations in either, PIK3CA or Tie2R (TEK).1,2 These mutations arise during embryonic development and result in somatic mosaicism.3.