Intramuscular Hemangioma of the Forearm with Phleboliths: A Case Report

Abstract

Intramuscular hemangiomas of the forearm are rare. Patients typically present with pain, discomfort, and progressive enlargement of the lesion. Diagnosis is often difficult due to their infrequency, deep location, and unfamiliar presentation. In this case report, we present a 47-year-old woman with an intramuscular hemangioma with phleboliths involving the forearm. The patient reported swelling in the right forearm for the past 20 years, which was insidious in onset, gradually progressive in size, and associated with dull aching pain. Upon examination, a soft 20×4 cm swelling was present over the right forearm involving the ulnar aspect, with a positive Tinel’s sign at mid-forearm level. Clinical differential diagnosis included lipomatosis, neurofibroma, and intramuscular hemangioma. On Magnetic Resonance Imaging (MRI), a heterogeneously enhancing serpentine lesion was noted involving the flexor compartment muscles of the right forearm. The patient underwent excision of the lesion, and histopathological examination confirmed intramuscular hemangioma. During the postoperative recovery period, all range of movements at the elbow joint and wrist were normal. No recurrence was noted up to two years of follow-up