Phleboliths are small, round lumps of calcium that form in a person’s veins. They often show up as white spots on pelvic X-rays, and they can be mistaken for kidney stones.

These calcifications are common, particularly in the pelvis. They are not usually a cause for concern and are rarely painful. However, if they do cause pain, treatments are available.

In this article, we look at the causes, symptoms, diagnosis, and treatment of phleboliths.

What are phleboliths?

Doctor and patient standing in hallway in discussion.
Phleboliths do not always cause symptoms, and in many cases are discovered accidentally through routine X-rays.

Phleboliths are round clusters of calcium that develop in the walls of a vein. They can vary in size but are usually around 5 millimeters across. They most commonly appear in the veins surrounding the pelvis.

Phleboliths are a type of vascular calcification. They are considered a sign of abnormality in the vein.

Phleboliths typically do not move and are harmless, but they may signal the presence of another condition. Many adults have phleboliths and are unaffected by them.

These lumps are more common in adults aged over 40 and appear at the same rate in men and women. Their frequency increases with age.

Causes

Researchers are uncertain why phleboliths form. They are usually present from birth, or congenital.

Non-genetic causes of phleboliths include:

  • abnormalities in the veins, or venous malformations, which slow the flow of blood and cause calcium to collect
  • damage to the walls of the vein
  • varicose veins
  • poor blood flow
  • constipation and straining, which can damage pelvic veins

Symptoms

Phleboliths often occur without any symptoms. A person may only learn of them after undergoing an unrelated X-ray or ultrasound.

However, depending on their size and location, phleboliths can cause the following signs and symptoms:

  • mild pain in the area
  • varicose veins or blood clots, caused by reduced blood flow
  • dilated veins and swelling in the area
  • constipation, when the phleboliths are in the pelvic area

Because the symptoms are similar to those of other conditions, phleboliths may be overlooked or misdiagnosed.

Diagnosis

x-ray of pelvis being held to light
An X-ray can be used to identify phleboliths in the body.

These lumps are typically detected on routine X-rays, are frequently occur with other vein abnormalities.

On an X-ray, phleboliths appear white or pale. A doctor may require additional scans, such as those from an ultrasound or MRI, to determine the exact location and extent of the phleboliths.

Depending on where the phleboliths are, they can be misdiagnosed as kidney stones. If a person experiences sharp pain in the abdomen, they may have kidney stones, rather than phleboliths.

Treatment

Most often, phleboliths require no treatment and do not indicate any risk of disease. If phleboliths are causing intense pain, a doctor may suggest the following treatment options:

  • Sclerotherapy. In this procedure, the vein containing the phlebolith is shrunk with an injection.
  • Endovascular laser therapy. This involves using a laser fiber to seal off the vein, and it is a common treatment for varicose veins.
  • Surgery. Depending on the severity of the vein abnormalities, a surgeon may need to remove the vein and surrounding tissue. This is performed under a general anesthetic.
  • Anti-inflammatories. Nonsteroidal anti-inflammatory drugs, such as naproxen, can reduce general pain caused by phleboliths.

Outlook

Phleboliths are small clusters of calcium found in veins. They are normally present from birth and can occur with vein abnormalities that require treatment.

In most cases, phleboliths do not indicate the presence of a severe condition. If these lumps are detected, a person may be referred to a specialist, to discuss treatment options.