Almousa Hisham M, Albesher Meshal B, Alsolami Afaf Lufayan, Al Mutairy Alyaa S
College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Otolaryngology Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Ear Nose Throat J. 2023 Aug 29:1455613231189148. doi: 10.1177/01455613231189148.
Intramuscular hemangiomas (IMH) are benign vascular tumors of the skeletal muscles. These tumors are uncommon in the head and neck region and usually affect the trunk and extremities. IMH of the masseter and trapezius muscles have been reported in the head and neck region. However, the sternocleidomastoid is extremely rare. In the current case report, we described a 25-year-old man with a rare case of intramuscular hemangioma involving the sternocleidomastoid muscle and reviewed the relevant literature. Contrast-enhanced computed tomography was initially obtained and showed a slightly hyperdense soft tissue mass. Head and neck magnetic resonance imaging (MRI) demonstrate a well-delineated hyperintense lesion on the T2 sequence suggestive of a soft tissue hemangioma. Subsequently, angioembolization using onyx was performed, followed by surgical excision of the mass under general anesthesia. Histopathological examination of the mass showed vascular proliferation within the skeletal muscles, and fatty tissue with an abundance of capillaries, which are consistent with capillary type intramuscular hemangioma. The patient was followed up in the clinic until the wound healed. Three months after surgery, no recurrence was observed. Preoperative angioembolization contributed to the success of IMH surgery by reducing morbidity, facilitating complete excision, and decreasing the risk of recurrence.
肌内血管瘤(IMH)是骨骼肌的良性血管肿瘤。这些肿瘤在头颈部区域并不常见,通常累及躯干和四肢。头颈部区域已报道过咬肌和斜方肌的肌内血管瘤。然而,胸锁乳突肌的肌内血管瘤极为罕见。在本病例报告中,我们描述了一名25岁男性,患有罕见的累及胸锁乳突肌的肌内血管瘤,并回顾了相关文献。最初进行了增强计算机断层扫描,显示出一个略高密度的软组织肿块。头颈部磁共振成像(MRI)在T2序列上显示出一个边界清晰的高信号病变,提示为软组织血管瘤。随后,使用Onyx进行了血管栓塞,然后在全身麻醉下对肿块进行了手术切除。肿块的组织病理学检查显示骨骼肌内有血管增生,以及富含毛细血管的脂肪组织,这与毛细血管型肌内血管瘤相符。患者在门诊随访直至伤口愈合。术后三个月,未观察到复发。术前血管栓塞通过降低发病率、促进完整切除和降低复发风险,有助于肌内血管瘤手术的成功。