Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 May 2:2019:6024039.
doi: 10.1155/2019/6024039. eCollection 2019.

Intramuscular Hemangioma of the Forearm with Flexion Contracture

Sunyarn Niempoog  1 , Waroot Pholsawatchai  1
Affiliations
Case Reports

Intramuscular Hemangioma of the Forearm with Flexion Contracture

Sunyarn Niempoog et al. Case Rep Orthop. .

Abstract

Intramuscular hemangiomas can be an infrequent but important cause of musculoskeletal pain. This report describes a 25-year-old male who presented with pain in the right forearm and contracture of the right hand for 4 years. Physical examination revealed severe tenderness of the midforearm with contracture of the flexor tendons in the index, middle, ring, and little fingers. Conventional radiography of the forearm revealed a soft tissue phlebolith. Magnetic resonance imaging showed a well-defined lobulated mass partially involving the FDP tendon. An intramuscular hemangioma within the deep anterior compartment of the forearm was suspected. Following surgical excision of the hemangioma, the patient's symptoms resolved completely. In conclusion, intramuscular hemangioma can be a rare cause of flexion contracture of the hands and should be considered as a cause of a flexion contracture that fails to respond to conservative treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preoperative physical examination revealed the flexion contracture of fingers in resting position (a). Passive extension on right index, middle, and ring fingers on the PIP joint and DIP joint was grossly limited (b).
Figure 2
Figure 2
MRI showed the hemangioma.
Figure 3
Figure 3
Surgery revealed the intramuscular mass infiltrating the FDP of the right forearm (a, b). The passive extension of the index finger was established (c). The heterogeneous, lobulated, rubbery, red-yellow mass (2 × 2 cm) consisted of hemorrhage, vascular invasion, and central necrosis (d).
Figure 4
Figure 4
Microphotograph of intramuscular hemangioma. The lesion is an ill-defined intramuscular mass composed of proliferation of predominant cavernous-type vascular channels (40x) (a).The vascular channels are lined by variably thick walls and contain blood components. Foci of phleboliths are identified (100x) (b). Metaplastic ossification is noted (400x) (c).
Figure 5
Figure 5
Active flexion and extension of MCP, PIP, and DIP joints of index, middle, ring, and little fingers, one year after surgical excision.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Enzinger F. M., Weiss S. W. Soft Tissue Tumors. 2nd ed. St Louis: CV Mosby Co; 1988. Benign tumors and tumor like lesions of blood vessels; pp. 745–756.
    1. Tang P., Hornicek F. J., Gebhardt M. C., Cates J., Mankin H. J. Surgical treatment of hemangiomas of soft tissue. Clinical Orthopaedics and Related Research. 2002;399:205–210. doi: 10.1097/00003086-200206000-00025. - DOI - PubMed
    1. Allen P. W., Enzinger F. M. Hemangioma of skeletal muscle.An analysis of 89 cases. Cancer. 1972;29(1):8–22. doi: 10.1002/1097-0142(197201)29:1<8::AID-CNCR2820290103>3.0.CO;2-A. - DOI - PubMed
    1. Fergusson I. L. C. Haemangiomata of skeletal muscle. British Journal of Surgery. 1972;59(8):634–637. doi: 10.1002/bjs.1800590815. - DOI - PubMed
    1. Kryzak T. J., Jr, Degroot H., III Adult Onset Flatfoot Associated with an Intramuscular Hemangioma of the Posterior Tibialis Muscle. Orthopedics. 2008;31(3):1–3. doi: 10.3928/01477447-20080301-24. - DOI - PubMed

Publication types

LinkOut - more resources