Large Cavernous Hemangioma of the Subscapularis Muscle - A Case Report Lee, Ki-Won; Lee, Hyun Il; Kim, Chung-Hwan; Kim, Tae-Kyung;
We report a case of intramuscular hemangioma in the subscapularis muscle and the resulting impairment of shoulder function in an adult patient. A nineteen-year-old female complained of shoulder pain and the development of a mass in the absence of previous trauma. Physical examinations, including lift-off and belly-press tests, showed abnormality. X-ray showed multiple calcifications in the front of the scapula. Magnetic resonance imaging showed a soft-tissue mass occupying almost the entire intramuscular portion of the subscapularis muscle. An arthroscopic examination excluded the possibility of a joint invasion, after which the entire mass was successfully removed by open excision. The displacement of the subscapularis by the mass was relieved after the surgery. Pathological diagnosis of the tissue confirmed a cavernous hemangioma. Both shoulder pain and function was improved after operation. There was no evidence of recurrence even at the 2-year follow-up. Rare forms of hemangioma adjacent to the shoulder joint could be successfully managed with surgical excision. Differential diagnosis, such as synovial chondromatosis, pigmented villo-nodular synovitis, and malignant sarcoma, should also be considered.
Beham A, Fletcher CD. Intramuscular angioma: a clinicopathological analysis of 74 cases. Histopathology. 1991;18(1):53-9.
Murphey MD, Fairbairn KJ, Parman LM, Baxter KG, Parsa MB, Smith WS. From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 1995;15(4):893-917.
Memis A, Arkun R, Ustun EE, Kandiloglu G. Magnetic resonance imaging of intramuscular haemangiomas with emphasis on contrast enhancement patterns. Clin Radiol. 1996;51(3):198-204.
Kang HJ, Jung SH, Song KW, Kim HS, Kang ES, Hahn SB. The features and treatment results of the hemangioma in upper extremity. J Korean Soc Surg Hand 2001;6(2):181-5.
Griffin N, Khan N, Thomas JM, Fisher C, Moskovic EC. The radiological manifestations of intramuscular haemangiomas in adults: magnetic resonance imaging, computed tomography and ultrasound appearances. Skeletal Radiol. 2007;36(11):1051-9.