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We report two cases with localized vascular malformations clinically resembling the "dominant lesion" seen in capillary malformation‐arteriovenous malformation (CM‐AVM) syndrome, however, lacking germline RASA1 variants but presenting double somatic RASA1 variants in affected tissue. Both patients presented with localized and superficial high‐flow vascular malformations were treated with surgery and laser therapy and showed partial resolution. The study underscores the rarity of somatic RASA1 variants, contributes to understanding the "second‐hit" pathophysiology in vascular lesions, and emphasizes the significance of clinical distinctions and genotyping for accurate diagnoses, offering implications for diagnosis, prognosis, and genetic counseling. [ABSTRACT FROM AUTHOR]

This article discusses a case study of a newborn male with a congenital haemangioma (CH), a rare benign vascular tumor present at birth. The CH showed rapid and partial involution over 6 months and was surgically excised without complications. Genetic analysis of the affected tissue revealed a pathogenic variant in the PIK3CA gene, which is associated with various cancers and non-malignant alterations. The patient also developed a nephroblastoma, but no PIK3CA mutations were detected in the renal tumor. This case highlights the importance of understanding the mechanisms involved in the development of benign or malignant tumors. [Extracted from the article]