CME OnDemand: 2022 AOFAS Annual Meeting-Intramuscular Haemangioma of Abductor Hallucis Muscle: A Rare Case Report

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This case report discusses a rare case of intramuscular haemangioma of the abductor hallucis muscle in an 18-year-old female student. The patient presented with a painful mass on her left foot that had been present for 3 years. There was no history of trauma, but the patient had undergone prior surgery at a local hospital. Despite the mass, the patient had good function in her foot.<br /><br />Radiological examination, including ultrasound and MRI, was performed to aid in diagnosis. Surgical treatment was chosen due to persistent pain and the progressive increase in the size of the lesion. The options for surgical treatment included partial excision, wide excision, or sclerotherapy. The chosen treatment was not specified in the report.<br /><br />Histopathological findings confirmed the diagnosis of intramuscular haemangioma. The report emphasizes that although this type of haemangioma is rare, it should be considered as a differential diagnosis. It is also mentioned that delayed diagnosis is common, with the condition often being mistaken for other benign vascular proliferations, lipoma, or fibroma. <br /><br />The report concludes that a team approach is necessary for correct diagnosis and treatment and that wide excision of the muscle is a feasible surgical option. The patient had a follow-up examination 2 years after the surgery, but the results were not provided.<br /><br />Intramuscular haemangiomas are slow-growing and benign yet locally aggressive tumors. They are difficult to distinguish from other benign vascular proliferations. Symptoms typically include pain and a mass. Conservative treatment can be considered for asymptomatic or mild cases, but surgical treatment is necessary for persistent pain, progressive growth, functional impairment, or patient concern.<br /><br />Overall, this case report highlights the importance of considering intramuscular haemangioma as a potential diagnosis and the need for a multidisciplinary approach to its management.

Asset Subtitle

Dimas R. Boedijono, MD, Andi Praja Wira Yudha Luthfi, MD

Keywords

intramuscular haemangioma

abductor hallucis muscle

18-year-old female

painful mass

foot

surgical treatment

diagnosis

histopathological findings

differential diagnosis

wide excision