Lu Hui, Chen Qiang, Yang Hu, Shen Hui
Department of Hand Surgery, the First Affiliated Hospital, College of Medcine, Zhejiang University Department of Hand Surgery, Zhejiang Province People's Hospital, Hangzhou, Zhejiang Province, P. R. China.
Medicine (Baltimore). 2017 Jan;96(3):e5939. doi: 10.1097/MD.0000000000005939.
Intramuscular hemangioma (IMH) is a rare congenital soft tissue tumor. Here, we report a case of IMH patient who had undergone several surgeries and other treatments that were all ineffective before he visited us.
This IMH patient was a 16-yearold male who was born with a tumor of unknown size in his right hand and forearm. On physical examination, the tumor and skin flap complex was seen with a size of 14 cm_12 cm in his right hand, and the multiple postoperative scars were shown on his right hand and forearm. The patient was not able to raise his right shoulder, and the ranges of motion of his right elbow, wrist, and finger were almost zero degrees.
Considering that the tumor had been surgically excised for several times and the multiple recurrences had affected adversely his daily life, an amputation of his right hand, forearm, and the part of his right arm was performed.
The pathological examination confirmed the diagnosis of IMH.
After the amputation surgery, the patient gained a functional recovery and the tumor did not recur during the 2 years after the surgery.
A treatment of choice should be personalized according to an IMH patient's overall situation. For an IMH patient like our case with a history of multiple tumor recurrences, we suggest that an amputation surgery should be performed as early as possible to avoid the repeated, but ineffective surgical excisions and the unnecessary sufferings.
肌内血管瘤(IMH)是一种罕见的先天性软组织肿瘤。在此,我们报告一例IMH患者,该患者在来我院就诊前已接受多次手术及其他治疗,但均无效。
该IMH患者为一名16岁男性,右手和前臂自出生就有一个大小不明的肿瘤。体格检查发现,其右手肿瘤及皮瓣复合体大小为14厘米×12厘米,右手和前臂有多处术后瘢痕。患者无法抬起右肩,右肘、腕和手指的活动范围几乎为零度。
鉴于该肿瘤已多次手术切除且多次复发对其日常生活产生不利影响,遂对其右手、前臂及右臂部分进行了截肢手术。
病理检查确诊为IMH。
截肢手术后,患者功能恢复,术后2年内肿瘤未复发。
应根据IMH患者的整体情况进行个性化治疗选择。对于像我们病例这样有多次肿瘤复发史的IMH患者,我们建议尽早进行截肢手术,以避免反复但无效的手术切除及不必要的痛苦。