Intramuscular hemangioma in the zygomaticus muscle: A rare case report presentation and diagnosis

Management of a rapidly enlarging supraclavicular mass of unknown aetiology

Intramuscular haemangiomas are benign tumours showing an extremely rare occurrence and making up less than 1% of all haemangiomas. The goal of this case report is to share our experience in treating a patient with an extremely rare intramuscular haemangioma, which occurred in the supraclavicular region VB level of the neck and extended towards the infraclavicular space, localised within and inferior to the trapezius muscle. The lesion was diagnosed by using multimodal imaging and a wide excision was performed with intraoperative feeding vessel ligation and a good postoperative result. The main difficulties regarding diagnosis and treatment include a lack of evidence-based guidelines, due to limited publications on this topic, the nature of the lesion frequently showing obscure anatomic localisation deep within muscles and unclear delineation, various anatomic origin requiring an individual treatment approach, inconclusive radiologic signs as well as non-specific symptoms.

Intramuscular cavernous malformation in the temporalis muscle: Diagnosis and treatment of a rare tumor in a rare site

In this case report we present a very rare case of intramuscular cavernous hemangioma in the temporalis muscle which was successfully managed with surgical excision with no evidence of recurrence in follow-up.

Intramuscular Hemangioma of the Sternocleidomastoid: A Rare Tumor in an Unusual Location

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.

Intramuscular hemangioma in the zygomaticus minor muscle: a case report and literature review

Intramuscular hemangioma is a rare vascular benign proliferation that can occur within any muscle, particularly in the trunk and extremities. In the head and neck region, the masseter muscle is most commonly involved, followed by the periorbital and sternocleidomastoid muscles. Diagnosing intramuscular hemangioma is challenging because there are no characteristic symptoms; instead, magnetic resonance imaging is the best imaging modality to diagnose these lesions. Complete surgical resection is the treatment of choice, although the local recurrence rate is high. Herein, we report a rare case of intramuscular hemangioma located in the zygomaticus minor muscle, which is related to smiling and usually runs along the orbicularis oculi muscle. Distinguishing or separating these two muscles is challenging. However, based on the muscle vector of the midface and radiological findings, the two muscles were successfully separated. The zygomaticus minor was cut very slightly to approach to the lesion and the muscle fibers were split to excise it. A follow-up examination revealed no nerve damage or muscle dysfunction at 4 weeks postoperatively. This rare case may serve as a reference for managing intramuscular hemangioma in the head and neck region.