Abstract
19 patients with intramuscular hemangioma (IMH) in the extremity have been treated at our institution over the last 15 years. The average age was 20 years (range, 1 to 70 years).
Involved sites were the lower extremity in 12 patients, and the upper extremity in 7. The mean follow-up period was 5.1 years (range, 0.5 to 15 years). Longstanding pain and swelling were common symptoms. Plain X-ray showed phlebolith in 10 patients. Magnetic resonance imaging, 13 patients, delineated the extent of the lesions, and revealed characteristic structures within the tumors. These two imaging modalities were informative for diagnosis and surgical treatment planning. Angiography and compued tomography were less valuable, although they also showed the lesions to some extent. Diagnosis of IMH was obtained preoperatively in 8 patients, however, the remaining 11 patients needed open biopsy. Extirpation of the tumors was performed in 17 patients, one of whom also received radiotherapy. Of the remaining two patients, one receieved only radiotherapy. The other, tumor was left untreated, because it was too extensive to be excised without significant morbidity. These two patients, had no major disability at the latest follow-up. Local recurrence occurred in 2 of the 17 surgically-treated patients. Complete extripation is needed for local control of the disease, but feasibility of the surgery depends on the tumor's location and size. Low dose radiotherapy may be a useful alternative, when the lesion is extensive, and the symptoms warrants.
