Subcutaneous lobular capillary hemangioma mimicking brachial plexus neurofibroma

Abstract

To describe the case of subcutaneous lobular capillary hemangioma (LCH) mimicking brachial plexus neurofibroma. Pyogenic granuloma or LCHs is benign vascular lesions affecting the superficial dermis or mucous membranes. Subcutaneous forms have been very rarely reported. We present the rare case of a 22-year-old female presented with a 5-year history of firm gradually progressive left supraclavicular swelling. The patient had an iatrogenic long thoracic nerve palsy from an exploration and partial excision 3 years back in another hospital and had developed axillary and suprascapular nerve palsy for the last 2 years. Imaging was suggestive of a large contrast-enhancing supraclavicular lesion involving the brachial plexus. The lesion was explored and total excision was achieved under neuromonitoring without any new deficits. The histopathological examination revealed a diagnosis of a LCH. Subcutaneous LCH involving the brachial plexus is a rare entity. Surgical excision assisted by neuromonitoring provides good outcomes. Subcutaneous LCH is a rare diagnosis but can mimic a neurofibroma of the brachial plexus and should be kept as a differential diagnosis.