Boedijono Dimas Radithya, Luthfi Andi Praja Wira Yudha
Department of Orthopaedics and Traumatology, Fatmawati General Hospital, Jakarta, Indonesia.
Department of Orthopaedics and Traumatology, Bhayangkara Tk.I R. Said Sukanto Police Hospital, Jakarta, Indonesia.
Int J Surg Case Rep. 2020;77:682-685. doi: 10.1016/j.ijscr.2020.11.035. Epub 2020 Nov 24.
Haemangioma is a slow growing benign soft tissue tumor and its presentation in the foot is rare. Intramuscular haemangioma (IH) are usually found before 30 years of age, with gender predominance is still inconclusive.
An 18-year-old woman came with pain and mass in the left foot for the past 3 years. Magnetic Resonance Imaging (MRI) of the left foot shown a heterogenous multilobulated mass, with previously thought originated from flexor digitorum brevis (FDB) muscle. Wide excision was performed and intraoperative findings showed that the mass actually originated from abductor hallucis muscle. Post-operative histopathological findings confirmed the diagnosis of cavernous-type of intramuscular haemangioma.
The rare occurrence of intramuscular haemangioma of the foot can cause a delayed diagnosis and treatment to the patient. The differential diagnosis include lipoma, fibroma, enlargement of the lymph nodes, compartment syndrome, hematoma, hernia, and soft-tissue sarcoma. Anytime a soft tissue mass is identified in the skeletal muscle of a young adult, haemangioma should be considered.
Literature research identified very few cases of intramuscular haemangioma of the foot. Wide excision of the muscle is a feasible surgical treatment option.
血管瘤是一种生长缓慢的良性软组织肿瘤，其在足部的表现较为罕见。肌内血管瘤（IH）通常在30岁之前被发现，性别优势仍无定论。
一名18岁女性因左脚疼痛和肿块前来就诊，症状已持续3年。左脚的磁共振成像（MRI）显示为一个异质性多叶肿块，之前认为起源于趾短屈肌（FDB）。进行了广泛切除，术中发现肿块实际上起源于拇展肌。术后组织病理学检查结果证实为海绵状型肌内血管瘤。
足部肌内血管瘤的罕见发生可能导致患者诊断和治疗延迟。鉴别诊断包括脂肪瘤、纤维瘤、淋巴结肿大、骨筋膜室综合征、血肿、疝和软组织肉瘤。在年轻成人的骨骼肌中发现软组织肿块时，应考虑血管瘤。
文献研究发现足部肌内血管瘤的病例极少。广泛切除肌肉是一种可行的手术治疗选择。
