CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(04): e676-e680
DOI: 10.1055/s-0040-1722588
Relato de Caso
Ombro e Cotovelo

Intramuscular Hemangioma: A Rare Cause of Omalgia[*]

Article in several languages: português | English
1   Medicina do Trabalho, Centro Hospitalar de Medicina do Trabalho, Centro Hospitalar Universitário São João, Serviço de Saúde Ocupacional, Porto, Portugal
,
Nuno A. Saldanha
1   Medicina do Trabalho, Centro Hospitalar de Medicina do Trabalho, Centro Hospitalar Universitário São João, Serviço de Saúde Ocupacional, Porto, Portugal
,
Pedro M. Matos
1   Medicina do Trabalho, Centro Hospitalar de Medicina do Trabalho, Centro Hospitalar Universitário São João, Serviço de Saúde Ocupacional, Porto, Portugal
,
Francisco S. Carvalho
1   Medicina do Trabalho, Centro Hospitalar de Medicina do Trabalho, Centro Hospitalar Universitário São João, Serviço de Saúde Ocupacional, Porto, Portugal
,
Graça Veiga
1   Medicina do Trabalho, Centro Hospitalar de Medicina do Trabalho, Centro Hospitalar Universitário São João, Serviço de Saúde Ocupacional, Porto, Portugal
,
Pedro Norton
1   Medicina do Trabalho, Centro Hospitalar de Medicina do Trabalho, Centro Hospitalar Universitário São João, Serviço de Saúde Ocupacional, Porto, Portugal
› Author Affiliations

Abstract

Intramuscular hemangiomas (IHs) are benign soft-tissue tumors that represent less than 1% of all hemangiomas. This clinical entity is rarely considered as a differential diagnosis in cases of musculoskeletal pain. A healthy 38-year-old woman presented to our office with complaint of left omalgia, with 8 months of evolution, limiting her daily activities. She reported the appearance of tumefaction in the previous 4 months. She was medicated with analgesic and antiinflammatory drugs with no clinical improvement. The objective examination showed limitation of left shoulder abduction (0–90°). The patient underwent a magnetic resonance imaging (MRI), in which a well-circumscribed nodular formation was detected in the deltoid muscle. Then, she underwent a biopsy, which confirmed the diagnosis of hemangioma. The patient was referred for sclerotherapy. Intramuscular hemangiomas are usually observed in young patients. The gold-standard examination for diagnosis is MRI, which often forestalls the need for a biopsy. In many cases, IHs are asymptomatic and tend to involute over time. Despite the low frequency of this clinical entity, it is important to place it as a diagnostic hypothesis in cases of chronic pain of the limbs in young patients with poor therapeutic response to antiinflammatory drugs and analgesia.

* Work developed at the São João University Hospital Center, Occupational Health Service, Porto, Portugal.


Financial Support

The authors declare that they have received no financial support for the research, authorship and/or publication of the present article.




Publication History

Received: 06 June 2020

Accepted: 17 September 2020

Article published online:
31 March 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Cohen AJ, Youkey JR, Clagett GP, Huggins M, Nadalo L, d'Avis JC. Intramuscular hemangioma. JAMA 1983; 249 (19) 2680-2682
  • 2 Ramon F. Tumors and Tumorlike Lesions of Blood Vessels. In: De Schepper AM, Parizel PM, De Beuckeleer L, Vanhoenacker F. eds. Imaging of Soft Tissue Tumors [Internet]. Berlin, Heidelberg: Springer Berlin Heidelberg; 2001. [citado 10 de Janeiro de 2020]. p. 225–44. Disponível em: http://link.springer.com/10.1007/978-3-662-07856-3_13
  • 3 Wierzbicki JM, Henderson JH, Scarborough MT, Bush CH, Reith JD, Clugston JR. Intramuscular hemangiomas. Sports Health 2013; 5 (05) 448-454
  • 4 Wild AT, Raab P, Krauspe R. Hemangioma of skeletal muscle. Arch Orthop Trauma Surg 2000; 120 (3-4): 139-143
  • 5 Fergusson IL. Haemangiomata of skeletal muscle. Br J Surg 1972; 59 (08) 634-637
  • 6 Kryzak Jr TJ, DeGroot 3rd H. Adult onset flatfoot associated with an intramuscular hemangioma of the posterior tibialis muscle. Orthopedics 2008; 31 (03) 280
  • 7 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 (02) e27-e29
  • 8 Scott JES. Haemangiomata in skeletal muscle. Br J Surg 1957; 44 (187) 496-501
  • 9 Brown RA, Crichton K, Malouf GM. Intramuscular haemangioma of the thigh in a basketball player. Br J Sports Med 2004; 38 (03) 346-348
  • 10 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 (05) e14343