Post-traumatic intramuscular hemangioma of the chest wall

Intramuscular hemangiomas (IMHs) are rare benign vascular tumors primarily occurring within skeletal muscle. Their incidence in the chest wall is even less common, often leading to misdiagnosis. This report discusses a case of IMH in a 51-year-old male with a history of chest trauma. It is the first case to be reported in Ethiopia. A 51-year-old male presented with a 2-year history of progressive swelling on the right lateral chest wall, accompanied by intermittent pain exacerbated by exercise. Three years prior, he sustained a chest injury in a car accident, with subsequent imaging showing no significant abnormalities other than a superficial laceration. Examination revealed a firm, smooth mass measuring 10 × 12 cm over the 8th to 10th ribs. Imaging and fine needle aspiration cytology (FNAC) identified a spindle cell neoplasm, leading to surgical excision, which confirmed the diagnosis of IMH. IMHs represent less than 1% of all hemangiomas, typically arising in individuals under 30. Although often asymptomatic, they can present as palpable masses, pain, or discomfort. Imaging such as computed tomography (CT) scans can assist in evaluation, while magnetic resonance imaging (MRI), though not performed in this case, is useful for diagnosis. Complete surgical excision remains the optimal treatment. This case underscores the importance of considering IMH in adults presenting with unexplained chest wall masses, particularly following trauma. Careful postoperative monitoring is recommended due to the risk of recurrence.