Lower limb intermuscular and intramuscular hemangioma in adults managed by Endovenous Laser Ablation (EVLA): a rare case

Abstract

Introduction: Hemangiomas are non-malignant neoplasms originating from vascular endothelial cells. Infantile and pediatric populations have a higher prevalence of these tumors, although their occurrence in adult individuals is infrequent. The manifestation of these neoplasms occurs within a few weeks following birth and then undergoes excessive growth. In certain instances, a process of minor involution occurs. Hemangiomas exhibit a higher prevalence among women in comparison to males. Due to the perplexing clinical presentation of this condition, it is imperative to use caution while making a diagnosis. This paper aims to examine a case of an uncommon hemangioma located in the cutaneous, subcutaneous, intermuscular, and intramuscular layers of the medial region of the left thigh in a 32-year-old male patient from Indonesia.

Case description: A 32-year-old male patient came to the hospital with a chief complaint of chronic pain in his left leg that has persisted for 20 years. The initial manifestation occurred in the form of a little protuberance like a corn kernel, localized on the medial aspect of the left thigh's upper region, during the patient's infancy at the age of two weeks. The observed lump had an initial hardness and subsequently increased in size. The physical examination of the medial upper left thigh showed a palpable lump measuring 2x3 cm. The mass was seen to be soft, painless, moveable, and non-pulsating. CT scan examination showed the presence of a soft tissue lesion in the left femur-popliteal region, which exhibits indistinct boundaries and irregular edges. Notably, it extends both intermuscularly and intramuscularly and also presses into the joint space. The patient stated that 14 days after EVLA therapy, the patient stated that the pain had disappeared by approximately 70% of the previous pain. The patient stated that the pain had disappeared by approximately 70% of the previous pain 14 days after EVLA therapy.

Conclusion: Intramuscular hemangiomas in the limbs are exceedingly uncommon, particularly in adult patients; it is important to consider hemangiomas as a potential differential diagnosis. Establishing a diagnosis and determining appropriate therapy and treatment necessitates the adoption of a team approach.