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Miro J. Unusual presentation of intramuscular hemangioma in abdominal oblique muscles. Clin Case Rep 2022; 10:e05383. [PMID: 35387288 PMCID: PMC8978788 DOI: 10.1002/ccr3.5383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/14/2022] [Indexed: 11/08/2022] Open
Abstract
Intramuscular hemangiomas are rare benign tumors that are difficult to diagnose. We report a successful case of intramuscular hemangioma excision involving the external oblique muscles. The mass was excised successfully, and histopathology confirmed the diagnosis of intramuscular hemangioma with a negative margin and no malignancy.
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Affiliation(s)
- Jameel Miro
- Surgical Oncology Umm Al‐Qura University Mecca Saudi Arabia
- Surgical Oncology Doctor Soliman Fakeeh Hospital Jeddah Saudi Arabia
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2
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Lee HS, Hong YC, Jung KJ, Yeo ED, Won SH, Jang SH, Ji JY, Lee DW, Yoon SJ, Kim WJ. A Huge Plantar Intramuscular Hemangioma in the Plantar Area Treated Surgically: A Case Report and Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179088. [PMID: 34501676 PMCID: PMC8431436 DOI: 10.3390/ijerph18179088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
Intramuscular hemangioma (IH) is rare, accounting for only 0.8% of all hemangioma cases. In particular, IH of the foot has only been reported a few times. In such cases, the symptoms typically include tenderness and swelling, often in relation to physical activity, but tingling or impaired function may also be present. Here, we report a patient who presented with a significant IH in the plantar area treated surgically. A 25-year-old female visited our hospital with pain in the plantar aspect of the right foot. She had noticed a mass about 10 years prior. She had previously experienced pain only when pressing the mass, but the pain subsequently became more regular pain and was exacerbated by exercise. In fact, the pain became so intense that she could not sleep well. Upon physical examination, mild swelling and tenderness of the plantar area were noted in the second to the fourth metatarsal. Sensation and motor reflexes were normal and the results of Tinel’s test were negative. Plain radiographs of the right foot revealed phleboliths scattered throughout the first to third intermetatarsal spaces. Magnetic resonance imaging revealed a space-occupying multilobulated mass (5.6 × 2.8 × 2.5 cm) located in the flexor digitorum brevis (FDB) muscle, which penetrated the plantar fascia and spread to the subcutaneous layer. In T2-weighted images, the lesion displayed a hyperintense signal compared to the surrounding skeletal muscle. Based on radiological findings, we suspected IH. The mass surrounded by the FDB muscle was exposed and completely removed via wide excision. IH consisting of cavernous-like vascular structures was diagnosed on pathology. At 1-year follow-up, the patient was almost asymptomatic and had recovered almost full range of motion in the plantar area. Histological analysis and surgery are recommended to remove intramuscular hemangiomas in the plantar area, but if the patient is not suitable for surgery, sclerotherapy or combination treatment should also be considered.
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Affiliation(s)
- Hong Seop Lee
- Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea;
| | - Yong Cheol Hong
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Korea; (Y.C.H.); (K.J.J.); (S.J.Y.)
| | - Ki Jin Jung
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Korea; (Y.C.H.); (K.J.J.); (S.J.Y.)
| | - Eui Dong Yeo
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul 05368, Korea;
| | - Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea;
| | - Si-Hyong Jang
- Department of Pathology, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Korea;
| | - Jae Young Ji
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Korea;
| | - Dhong Won Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea;
| | - Sung Joon Yoon
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Korea; (Y.C.H.); (K.J.J.); (S.J.Y.)
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Korea; (Y.C.H.); (K.J.J.); (S.J.Y.)
- Correspondence:
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3
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Shen Z, Zhang D, Li G, Huang D, Qiu Y, Xie C, Zhang X, Wang X, Liu Y. Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma. Laryngoscope 2021; 131:2724-2728. [PMID: 34160868 DOI: 10.1002/lary.29703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH). STUDY DESIGN Retrospective study. METHODS From February 2009 to May 2020, 101 patients with ANPLH were reviewed and analyzed. RESULTS Symptoms of ANPLH were frequently displayed as abnormal pharyngeal sensation and functional defection. According to lesion location, ANPLH was divided into five categories including nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, and mixed types. The mixed type constitutes the highest portion, and the nasopharyngeal type is the least in our cohort. Most lesions could resect through natural cavity under endoscopy. Patients with mixed lesions had a higher rate of postoperative recurrence and planned multiple surgeries. Acceptable but not severe intraoperative and postoperative complications occurred in our patient cohort. CONCLUSIONS Patients with ANPLH are always symptomatic and even functional defective, which can be classified into five categories based on lesion location. For these patients, endoscopic surgery through natural cavity is recommended to remove lesions with fewer complications and favorable clinical outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
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Affiliation(s)
- Zhe Shen
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Diekuo Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Guo Li
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Donghai Huang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yuanzheng Qiu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Changning Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xin Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xingwei Wang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yong Liu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Hospital, Central South University, Changsha, People's Republic of China
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Yu D, Choi JH, Jeon I. Intramuscular hemangioma with hemorrhagic transformation arising from paraspinal muscles of posterior neck: A case report. Medicine (Baltimore) 2020; 99:e21741. [PMID: 32872061 PMCID: PMC7437785 DOI: 10.1097/md.0000000000021741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Hemangiomas are usually found in cutaneous or mucosal layers, less than 1% of hemangiomas develop in skeletal muscles. Intramuscular hemangioma (IH) in the head and neck areas is relatively infrequent, accounting for 15% of IH. Most of them are identified as a benign mass, and rapid changes in size or internal bleeding are rare. PATIENT CONCERNS A 60-year-old female patient presented with a 2-week history of sudden onset posterior neck pain. There was no neurological deficit except limited neck motion due to pain. The palpable mass was noted on the paraspinal muscles of cervicothoracic junction, which was located midline to left side portion with tenderness. DIAGNOSES Magnetic resonance imaging demonstrated a round shaped, multi-lobulated, and well-defined mass lesion (4.1 × 2.6 × 0.9 cm) embedded from the inter-spinous space of T1-2 to the left paraspinal muscles. The lesion was iso-intense on T2-weighted images (WI), iso- to slightly low-intense on T1-WI, heterogeneous enhancement of intra- and peri-mass lesion on contrast-enhanced T1-WI. Vascular structures presented as signal voids were identified internally and around the mass lesion. Histological examination revealed a mixed-type hemangioma. INTERVENTIONS The mass was removed completely including some of the surrounding muscles where boundaries were unclear between the mass and surrounding muscles with ligation of peritumoral vessels. Dark-brown colored blood was drained from the ruptured tumor capsule during the dissection. There was no bony invasion. OUTCOMES The preoperative symptoms improved immediately after the operation. There is no residual or recurrence lesion by the 15-months follow-up. LESSONS IH with hemorrhagic transformation in the head and neck is extremely rare. In the case of intramuscular tumors accompanied by a sudden onset of severe acute pain, we recommend considering a differential diagnosis of IH with hemorrhagic transformation. Complete resection of the tumor mass including surrounding muscles is required to prevent recurrence.
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Affiliation(s)
| | - Joon Hyuk Choi
- Department of Pathology, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, South Korea
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5
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Liu Y, Li R, Liu Z, Wang S, Lu L. Intramuscular hemangioma within the biceps brachii causing the limitations of elbow extension and forearm pronation: A case report. Medicine (Baltimore) 2019; 98:e14343. [PMID: 30702620 PMCID: PMC6380852 DOI: 10.1097/md.0000000000014343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Intramuscular hemangiomas are rare benign vascular neoplasms, merely accounting for 0.8% of all hemangiomas. Moreover, there are few case reports of intramuscular hemangiomas in the upper extremities. PATIENT CONCERNS A 24-year-old male patient presented with a 5-year history of intermittent pain of the right elbow joint. He had observed a swelling of the right cubital fossa over the past 2 years, leading to the limitations of elbow extension and forearm pronation. DIAGNOSIS The patient was diagnosed with intramuscular hemangioma of the biceps brachii. INTERVENTIONS Surgical excision of the tumor was performed for this patient and postoperative early functional exercises were permitted. OUTCOMES The movements of the right elbow and forearm reached the normal range of motion at 5 weeks after surgery. There was no evidence of recurrence during the 5-month follow-up. LESSONS Optimal management of intramuscular hemangioma is critical, including precise evaluation, good microsurgical technique and early functional exercises, which may result in a satisfying outcome.
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6
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Ferri E, Pavon I, Armato E. Intramuscular cavernous hemangioma of the sternocleidomastoid muscle: An unusual neck mass. Otolaryngol Head Neck Surg 2016; 137:682-3. [PMID: 17903594 DOI: 10.1016/j.otohns.2007.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Revised: 04/03/2007] [Accepted: 04/05/2007] [Indexed: 11/26/2022]
Affiliation(s)
- Emanuele Ferri
- Otorhinolaryngology Unit--Surgical Department, Hospital of Dolo, Dolo, Venice, Italy.
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Intramuscular Hemangioma in the Anterior Scalene Muscle Diagnosed by Core Needle Biopsy. Clin Exp Otorhinolaryngol 2015; 8:298-301. [PMID: 26330928 PMCID: PMC4553364 DOI: 10.3342/ceo.2015.8.3.298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 08/07/2014] [Accepted: 08/13/2014] [Indexed: 11/08/2022] Open
Abstract
Intramuscular hemangioma (IMH) is a rare, benign vascular lesion that frequently develops within skeletal muscles. Preoperatively, accurate diagnosis of IMH is often extremely difficult because of nonspecific clinical findings and the inaccuracy of fine-needle aspiration cytology. IMH is suspected in only 8% of preoperative diagnoses before surgical exploration. Here, we report a case of a 44-year-old man with a huge IMH in the anterior scalene muscle that was preoperatively diagnosed using ultrasonography-guided core needle biopsy, and was successfully treated based on preoperative clinical information.
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8
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Shah PP, Dubhashi SP, Choudhary K. Anterior abdominal wall haemangioma with inguinal extension. J Clin Diagn Res 2015; 8:ND15-6. [PMID: 25584266 DOI: 10.7860/jcdr/2014/9781.5190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 09/20/2014] [Indexed: 11/24/2022]
Abstract
Haemangioma are common benign vascular tumour but Intramuscular haemangiomas are rare tumours comprising less than 1% of all. The most frequent sites are extremities, head and neck whereas abdominal wall is a quiet rare location. Ultrasonography is an appropriate initial diagnostic modality and MRI is the investigation of choice. A rare case presented to us as Intramuscular haemangioma of anterior abdominal wall with inguinal extension. Ultrasonography with Doppler study and MRI was suggestive of same finding. Intraoperatively patient had huge haemangioma involving external oblique, internal oblique and transverse abdominus muscle. Wide local excision with meshplasty was done as part of muscle had to be removed. Histology confirmed the diagnosis of Intramuscular Haemangioma.
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Affiliation(s)
- Priti P Shah
- Associate Professor, Department of Surgery, Padamashree Dr D Y Patil Medical College , Pimpri, Pune, India
| | - Siddharth P Dubhashi
- Professor, Department of Surgery, Padamashree Dr D Y Patil Medical College , Pimpri, Pune, India
| | - Kaushal Choudhary
- Senior Resident, Department of Surgery, Padamashree Dr D Y Patil Medical College , Pimpri, Pune, India
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9
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Jang KM, Park SW, Kim YB. An Intramuscular Hemangioma at the Cervical Muscle: A Case Report. KOREAN JOURNAL OF SPINE 2015; 12:196-9. [PMID: 26512283 PMCID: PMC4623183 DOI: 10.14245/kjs.2015.12.3.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/04/2015] [Accepted: 09/04/2015] [Indexed: 11/19/2022]
Abstract
Intramuscular hemangioma (IMH) primarily develops in the skeletal muscles of the limbs or trunk. The occurrence of IMH in the neck muscle is very rare. In the present report, we describe a case of IMH in the posterior neck muscle. A 58-year-old woman presented with a mass on the right posterior neck area, which had developed 2 years previously. The tumor was round in shape, had a size of 3.5×3.0 cm, and was fixed to the surrounding soft tissue. The patient complained of mild dull pain and tenderness at the mass without reddish discoloration. The mass showed a diurnal variation in size - the mass grew in size in the morning and became smaller in the afternoon. Preoperative study confirmed the vascular nature of the tumor. During peritumoral dissection, the mass shrank rapidly following profuse bleeding and arterial cauterization, and hence, it was difficult to distinguish the mass from the surrounding tissues. A total resection was possible with careful dissection of its fibrotic boundary. Based on the histological findings, a definitive diagnosis of cavernous type IMH was made. An initial suspicion of IMH, according to the clinical findings, would be helpful for decision making of further evaluations and surgical plan.
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Affiliation(s)
- Kyoung-Min Jang
- Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seung-Won Park
- Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young-Baeg Kim
- Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea
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Uslu M, Beşir H, Turan H, Bozkaya H, Erdem H. Two different treatment options for intramuscular plantar hemangioma: surgery versus percutaneous sclerotherapy. J Foot Ankle Surg 2014; 53:759-62. [PMID: 25128310 DOI: 10.1053/j.jfas.2014.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Indexed: 02/03/2023]
Abstract
Intramuscular hemangiomas are benign neoplasms usually seen in children and adolescents. They tend to occur in the deep fascia and muscle and more often in the lower extremity, although they are rarely encountered in the plantar musculature. Surgical excision, ultrasound- or fluoroscopic-guided percutaneous sclerotherapy, and angiographic embolization are all treatment options. Surgical excision is the most prevalent form of therapy, although this can be difficult in the hands and feet. For this reason, ultrasound- and fluoroscopic-guided percutaneous sclerotherapy is a useful treatment option for pedal intramuscular hemangioma. In the present report, we describe 2 cases of intramuscular hemangioma in children, 1 treated by excision and 1 by percutaneous sclerosis.
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Affiliation(s)
- Mustafa Uslu
- Assistant Professor, Department of Orthopaedics and Traumatology, Düzce University School of Medicine, Düzce, Turkey.
| | - Halit Beşir
- Department of Radiology, Düzce University School of Medicine, Düzce, Turkey
| | - Hakan Turan
- Department of Dermatology, Düzce University School of Medicine, Düzce, Turkey
| | - Halil Bozkaya
- Department of Radiology, Ege University School of Medicine, Izmir, Turkey
| | - Havva Erdem
- Department of Pathology, Düzce University School of Medicine, Düzce, Turkey
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Wierzbicki JM, Henderson JH, Scarborough MT, Bush CH, Reith JD, Clugston JR. Intramuscular hemangiomas. Sports Health 2014; 5:448-54. [PMID: 24427416 PMCID: PMC3752185 DOI: 10.1177/1941738112470910] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Intramuscular hemangiomas are common in the general population and often present at medical and surgical clinics. Unfortunately, unfamiliarity with these lesions has led to a high percentage of misdiagnoses, inappropriate workup, and unnecessary referrals. Evidence Acquisition: A literature search was performed using Medline, Embase, PubMed, and Cochrane. The relevant articles and referenced sources were reviewed for additional articles that discussed the epidemiology, pathophysiology, investigation, and management of intramuscular hemangiomas. Clinical experience from experts in orthopaedics, musculoskeletal pathology, and musculoskeletal radiology was compared. The selected case studies are shared cases of the authors. Results and Conclusion: The pathophysiology of these lesions is not completely understood, but much can be implied from their underlying vascular nature. Isolated lesions are benign tumors that never metastasize but tend to enlarge and then involute over time. Magnetic resonance imaging is the imaging modality of choice. If a systemic disorder or malignancy is not suspected or has been ruled out, conservative management is the treatment of choice for most intramuscular hemangiomas.
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Affiliation(s)
- Joseph M Wierzbicki
- Primary Care Sports Medicine Fellowship, Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida
| | - Jeffrey H Henderson
- Primary Care Sports Medicine Fellowship, Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida
| | - Mark T Scarborough
- Department of Orthopaedic Oncology, Orthopaedic and Sports Medicine Institute, University of Florida, Gainesville, Florida
| | - Charles H Bush
- Department of Radiology, University of Florida, Gainesville, Florida
| | - John D Reith
- Department of Pathology, Immunology, and Laboratory Medicine and the Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - James R Clugston
- Primary Care Sports Medicine Fellowship, Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida
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12
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Effect of electrochemotherapy in treating patients with venous malformations. Chin J Integr Med 2013; 19:387-93. [DOI: 10.1007/s11655-013-1450-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Indexed: 10/27/2022]
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13
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Van Abel KM, Carlson ML, Janus JR, Torres-Mora J, Moore EJ, Olsen KD, Link MJ. Intramuscular hemangioma of the scalene musculature masquerading as a paraganglioma: a case series. Am J Otolaryngol 2013; 34:158-62. [PMID: 23159015 DOI: 10.1016/j.amjoto.2012.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/17/2012] [Indexed: 11/18/2022]
Abstract
Intramuscular hemangiomas (IMHs) are uncommon benign vascular lesions, which develop in skeletal muscle. Herein, two cases of IMHs involving the cervical scalene musculature are presented. Such lesions are exceedingly rare, and can be difficult to distinguish from vagal paragangliomas based on clinical presentation, exam, and radiography. Complete surgical excision is the treatment of choice, and was successful in our two index patients. While rare, IMHs of the scalene muscles should be considered in the differential diagnosis of deep neck space masses.
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Affiliation(s)
- Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, MN 55905, USA
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14
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Ultrasound-guided core-needle biopsy and magnetic resonance imaging in the accurate diagnosis of intramuscular haemangiomas of the head and neck. The Journal of Laryngology & Otology 2012; 126:391-4. [PMID: 22258504 DOI: 10.1017/s0022215111003161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Intramuscular haemangiomas of the digastric muscle are often misdiagnosed due to their low incidence and non-specific manifestation. Only two out of six previously reported cases were diagnosed correctly before excision. Ultrasound may not reveal their vascularity, and fine-needle aspiration biopsy is unhelpful as it reveals only blood. METHODS A case of intramuscular haemangioma of the posterior belly of the digastric muscle is described. Previously reported cases are reviewed. Investigations used to diagnose the lesions and reasons for their common failure are discussed. RESULTS Core-needle biopsy led to the correct histological diagnosis, and magnetic resonance imaging precisely located the lesion within the digastric muscle. CONCLUSION Core-needle biopsy was safely used in the diagnosis of an intramuscular haemangioma. The combination of core-needle biopsy and meticulous review of magnetic resonance imaging enables accurate diagnosis pre-operatively.
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Abstract
Intramuscular tumours of the head and neck often represent a differential diagnostic challenge. We report the rare case of an intramuscular haemangioma arising from the sternocleidomastoid muscle in the 6th decade. Pre-operative diagnosis was difficult, as these tumours are extremely uncommon in the head and neck region, with only very few cases reported in the literature. Due to the marked tendency of intramuscular hemangiomas to recur, accurate preoperative diagnosis forms the basis of adequate surgical therapy with sufficient safety margins.
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Mitsionis GI, Pakos EE, Kosta P, Batistatou A, Beris A. Intramuscular hemangioma of the foot: A case report and review of the literature. Foot Ankle Surg 2010; 16:e27-9. [PMID: 20483123 DOI: 10.1016/j.fas.2009.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 05/17/2009] [Accepted: 05/23/2009] [Indexed: 02/04/2023]
Abstract
Intramuscular hemangiomas (IHs) are rare benign neoplasms usually seen in children, adolescents and young adults. Although lower extremities are the commonest localization, the localization at the foot is extremely rare since only a few cases have been reported. We report a case of mixed type IH of the flexor digitorum brevis muscle in a 12-year-old boy who was treated with surgical excision, with wide surgical margins.
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Affiliation(s)
- Gregory I Mitsionis
- The Department of Orthopaedic Surgery, University Hospital of Ioannina, University of Ioannina, School of Medicine, Ioannina, Greece.
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Cophignon J, d'Hermies F, Civit T. [Vascular tumors of the orbit]. Neurochirurgie 2010; 56:197-212. [PMID: 20303554 DOI: 10.1016/j.neuchi.2010.02.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 01/21/2010] [Indexed: 10/19/2022]
Abstract
Vascular tumors of the orbit include capillary hemangioma, cavernous hemangioma, hemolymphangioma, hemangiopericytoma and a few rare tumors. Capillary hemangioma and hemolymphangioma, occurring mainly in children, are covered in the chapter devoted to childhood tumors. In this chapter, cavernous hemangioma and hemangiopericytoma are discussed as well as rare vascular tumors. Although orbital varix is not a tumor, it is also considered because of the diagnostic problems and the close correlation of orbital varix with a true tumor: hemolymphangioma.
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Affiliation(s)
- J Cophignon
- Service de neurochirurgie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France
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18
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Virich G, Parmar S, Wharton S. Intramuscular haemangioma of the head and neck—a diagnostic dilemma. EUROPEAN JOURNAL OF PLASTIC SURGERY 2010. [DOI: 10.1007/s00238-009-0367-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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19
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Capote A, Acero J, García-Recuero I, Rey J, Guerra B, de Paz V. Infratemporal-Preauricular-Cervical Approach for Resection of a Cavernous Intramasseteric Hemangioma: A Case Report. J Oral Maxillofac Surg 2008; 66:2393-7. [PMID: 18940514 DOI: 10.1016/j.joms.2007.06.650] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Revised: 11/28/2006] [Accepted: 06/06/2007] [Indexed: 11/15/2022]
Affiliation(s)
- Ana Capote
- Oral and Maxillofacial Surgery, Oral and Maxillofacial Institute Dr Julio Acero, Madrid, Spain.
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20
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Desai SC, Gopal M, Narayan A. A rare intramuscular hemangioma - case report. Indian J Surg 2008; 70:250-1. [PMID: 23133075 PMCID: PMC3452418 DOI: 10.1007/s12262-008-0072-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2007] [Accepted: 02/20/2008] [Indexed: 10/21/2022] Open
Abstract
Intramuscular hemangiomas are rare, slow growing, angiomatous tumors, generally asymptomatic, and rarely presenting with complications. We report a rare case of a Hemangioma of the Flexor Digitorum Superficialis in a 13-year-old boy, present since birth and with extensive involvement, necessitating excision of the muscle. The patient is presently doing well, barring minimal weakness in finger flexion.
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Affiliation(s)
- Sanjay C Desai
- Department of Vascular and Endovascular Surgery, M.S. Ramaiah Medical College and Hospital, M.S.R.I.T Post, New B.E.L Road, Bangalore, 560 054 India
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21
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Moumoulidis I, Durvasula VS, Jani P. An unusual neck lump: intramuscular haemangioma of the sternocleidomastoid muscle. Eur Arch Otorhinolaryngol 2007; 264:1257-60. [PMID: 17593381 DOI: 10.1007/s00405-007-0372-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Accepted: 02/09/2007] [Indexed: 10/23/2022]
Abstract
Neck lumps can often present a diagnostic dilemma, with a wide pre-operative differential diagnosis. We present an unusual case of an intramuscular haemangioma arising in the sternocleidomastoid muscle. Pre operative diagnosis is often difficult, as these lesions are extremely rare in the head and neck region and only few sporadic cases have been reported in the literature. We report the presentation diagnosis and management of intramuscular haemangiomas of the sternocleidomastoid muscle.
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Affiliation(s)
- I Moumoulidis
- Department of Otolaryngology-Head and Neck Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
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22
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Mandel L, Surattanont F. Clinical and imaging diagnoses of intramuscular hemangiomas: the wattle sign and case reports. J Oral Maxillofac Surg 2004; 62:754-8. [PMID: 15170294 DOI: 10.1016/j.joms.2003.05.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Louis Mandel
- Salivary Gland Center, Columbia University School of Dentistry and Oral Surgery, New York-Presbyterian Hospital, NY 10032, USA.
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23
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Giudice M, Piazza C, Bolzoni A, Peretti G. Head and neck intramuscular haemangioma: report of two cases with unusual localization. Eur Arch Otorhinolaryngol 2003; 260:498-501. [PMID: 12748867 DOI: 10.1007/s00405-003-0626-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2003] [Accepted: 03/28/2003] [Indexed: 10/26/2022]
Abstract
Head and neck intramuscular haemangioma (IMH) is a benign, uncommon neoplasm arising most frequently in the masseter and trapezius muscles. It usually appears as an enlarging mass without specific clinical features and is therefore frequently misdiagnosed. We report two cases of IMH at unusual localizations: one involving the pterygoid muscles in a 30-year-old female and another one originating from the thyrohyoid muscles in a 38-year-old male. Preoperative evaluation included routine ENT examination, ultrasound (US) and CT scan. The preoperative clinical diagnoses were lymphangioma of the parapharyngeal space in the first case and atypical thyroid duct cyst in the second. Both patients were treated with open-neck approaches. The histopathologic diagnosis was capillary-type IMH in the first patient and cavernous-type IMH in the second. Postoperative courses were uneventful, and the patients were discharged within a few days. Clinical and US follow-ups were negative at 50 and 20 months, respectively. Preoperative diagnosis of head and neck IMH is rendered difficult by its rarity and non-specific clinical findings. Ample surgical excision is required for an adequate cure due to the frequent microscopically infiltrative pattern of diffusion of such a tumor into skeletal muscles, and long-term follow-up is mandatory to promptly treat any recurrence.
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Affiliation(s)
- Marco Giudice
- Department of Otolaryngology, University of Brescia, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy
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Kiratli H, Bilgiç S, Cağlar M, Söylemezoğlu F. Intramuscular hemangiomas of extraocular muscles. Ophthalmology 2003; 110:564-8. [PMID: 12623822 DOI: 10.1016/s0161-6420(02)01887-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To report two patients, 3 and 40 years of age, respectively, each of whom had an isolated intramuscular hemangioma of an extraocular muscle. DESIGN Two retrospective, interventional case reports. INTERVENTION Incisional biopsy and short-term oral corticosteroids. MAIN OUTCOME MEASURES Clinical observation and pathologic examination of specimens and tumor status, visual acuity, and ocular motility at final follow-up. RESULTS Orbital magnetic resonance imaging revealed that, compared with other extraocular muscles, the tumor was isointense on T1-weighted scans and hyperintense on T2-weighted images. Marked homogeneous enhancement was observed after contrast agent administration. Biopsy results showed a hemangioma of the lateral rectus muscle with predominantly capillary-like small vessels in the child and a mixed small and large vessel type hemangioma of the medial rectus muscle in the adult. CONCLUSIONS Intramuscular hemangiomas may cause painless, isolated extraocular muscle enlargement in children and in adults without disturbing the ocular motility. The tumors do not seem to be sensitive to systemic corticosteroid therapy.
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Affiliation(s)
- Hayyam Kiratli
- Department of Ophthalmology, Ocular Oncology Service, Hacettepe University School of Medicine, Sihhiye TR-06100, Ankara, Turkey
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Abstract
Intramuscular hemangioma is an uncommon tumor that usually involves an extremity. They rarely occur after the age of 30. We report a case of an intramuscular hemangioma occurring on the back of a 39-year-old man. Histopathologically, the tumor consisted mainly of large vessels between the muscle fibers. Phleboliths were observed in some of the vessel walls.
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Affiliation(s)
- Y C Kim
- Department of Dermatology, College of Medicine, Dankook University Hospital, Cheonan, Korea
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