Hemangioma of skeletal muscle

Intramuscular hemangiomas are rare benign tumors, making up 0.8% of all hemangiomas. They are of interest to the surgeon because their location may present considerable therapeutic challenge since radiographic work-up of the soft- tissue mass by magnetic resonance imaging (MRI) may be suspicious for malignancy. The definitive diagnosis is made by histological study of the surgical and/or biopsy specimen. Patients with intramuscular hemangiomas may have soft-tissue complaints, such as pain and swelling, present for years. The gross and microscopic appearance of intramuscular hemangiomas is variable. Grossly, the capillary type is nonvascular and spongy in appearance, whereas the cavernous type is composed of large, thin-walled, dilated vessels lined by flattened endothelial cells. In general, wide excision is the treatment of choice to prevent local recurrence, but every patient with intramuscular hemangioma should be treated individually after evaluating the tumor location, accessibility, and depth of invasion, the patient's age, and cosmetic considerations. From October 1, 1989, to June 30, 1997, 11 patients underwent surgical treatment with the definitive histological diagnosis of intramuscular hemangioma. Pain upon activity but also at rest as well as swelling were the major symptoms. The average duration of symptoms was 13 months (range 1 month to 5 years). After a mean follow- up of 3 years and 4 months (range 12 months to 9 years), one of the patients has developed a recurrence; all remaining patients enjoy pain relief without any recurrence.