Tripathi Ashutosh Chandraprakash, Baitule Rajendra Wamanrao, Rathod Yogesh Bhimrao, Pundkar Ganesh Narayanrao, Bhutada Gaurav Pawan
Department of Orthopaedic Surgery, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, Maharashtra, India.
J Orthop Case Rep. 2022 Oct;12(10):83-86. doi: 10.13107/jocr.2022.v12.i10.3378.
Subcutaneous hemangioma is a rare variant of slow-flowing venous malformation. It occurs in both adults and children and is more common in women. It exhibits an aggressive growth pattern, can occur anywhere in the body, and may recur after resection. This report shows a rare localization of hemangioma in the retrocalcaneal bursa.
A female patient, age 31, presented with swelling and pain over the retro calcaneum region for 1 year. The pain in the retrocalcaneal region has increased with gradual intensity over the past 6 months. The swelling she described to be insidious in onset and gradually progressive. Examination findings at presentation were a middle-aged female with diffuse swelling in the retrocalcaneal region with a size of 2 cm by 1.5 cm. Based on the X-ray, we defined it to be myositis ossificans. With this view in mind, we admitted the patient and surgically excised the area. We operated by posteromedial approach and sent the specimen for histopathology. Pathology revealed calcified bursa. Microscopically, it was hemangioma with phleboliths and osseous metaplasia. The post-operative period was uneventful. The patient's pain was reduced, and overall performance was good at follow-up.
This case report highlights the importance for surgeons, pathologist to consider cavernous hemangioma as a differential diagnosis for retrocalcaneal swellings.
皮下血管瘤是一种罕见的缓慢流动型静脉畸形变体。它在成人和儿童中均有发生,女性更为常见。它呈现侵袭性生长模式,可发生于身体任何部位,切除后可能复发。本报告展示了血管瘤在跟腱后滑囊的罕见定位。
一名31岁女性患者,足跟后部区域肿胀疼痛1年。过去6个月里,跟腱后区域的疼痛逐渐加剧。她描述肿胀起病隐匿且逐渐进展。初诊时的检查结果为一名中年女性,跟腱后区域弥漫性肿胀,大小为2厘米×1.5厘米。基于X线检查,我们将其诊断为骨化性肌炎。基于此诊断,我们收治了该患者并对该区域进行了手术切除。我们采用后内侧入路进行手术,并将标本送去做组织病理学检查。病理显示为钙化滑囊。显微镜下,为伴有静脉石和骨化生的血管瘤。术后恢复顺利。患者疼痛减轻,随访时整体状况良好。
本病例报告强调了外科医生、病理学家将海绵状血管瘤作为跟腱后肿胀鉴别诊断的重要性。