Intramuscular hemangioma presenting as pathological femur fracture: A case report

Abstract

Hemangioma is a common benign soft-tissue tumor; however, intramuscular hemangioma presenting with a pathological fracture is an infrequent occurrence. Imaging plays a key role in diagnosing this entity. We report a case of a 30-year-old male who presented with a pathological fracture of the left femur following trivial trauma. Clinical examination was remarkable for a significant soft-tissue swelling which on further radiological investigation revealed a soft-tissue mass lesion in the left thigh muscles having multiple vascular channels and phleboliths extending into femoral cortex and medulla causing a pathological fracture. Diagnosing it as an aggressive hemangioma, the main feeder artery was embolized by polyvinyl alcohol particles. The patient is on traction and follow-up. Intramuscular hemangioma causing pathological fracture is extremely rare. Understanding the typical and atypical radiological findings of an intramuscular hemangioma will impede misdiagnosis, and unnecessary tissue sampling, and allow for expedited and appropriate management.