Intercostal Muscle Cavernous Haemangioma: A Chest Wall Pandora’s Box: Intercostal muscle cavernous hemangioma

Abstract

Background: Haemangiomas are uncommon chest wall tumours arising outside the rib cage. Their occurrence in intercostal muscle is extremely rare. Aim: We describe a case of intercostal muscle cavernous haemangioma as a differential diagnosis for chest wall swelling. Case description: We describe an 18-year-old male patient with an asymptomatic left-sided chest wall swelling. Contrast-enhanced computed tomography revealed a well-defined homogenously non-enhancing mass lesion arising from the seventh intercostal muscle with differential diagnoses of various chest wall tumours. Clinical presentation and imaging findings were inconclusive, but histopathological examination following excision biopsy revealed a cavernous haemangioma. The present case emphasizes the importance of histopathological diagnosis when clinical and radiological examination is inconclusive. Hence, it is necessary to consider intercostal muscle haemangiomas as a differential diagnosis for chest wall tumours in the absence of a feeding vessel. Conclusion: Despite its rare occurrence, intercostal muscle haemangioma must be considered as a differential diagnosis in chest wall tumours even in the absence of a feeding vessel. We believe that histopathology can provide a definitive diagnosis when most investigative procedures are inconclusive.

Intercostal hemangiomas coexisting with multiple hepatic hemangiomas: Clinical and imaging findings in a single case report with a review of the literature

“…At present, the most commonly used classification system is based on the type of vascular structure, which includes 5 subtypes: capillary hemangioma, cavernous hemangioma, VH, arteriovenous hemangioma, and mixed hemangioma. [5] Pathology confirmed that both tumors in our patient were VHs. Although IH is a benign tumor, it is somewhat aggressive.…”

“…[10,14] IHs are usually considered to be congenital or due to trauma. [5,6] Our patient had no history of chest trauma, but had MHHs. Hemangiomas can be divided into a variety of subtypes.…”

“…[8] In addition, due to the potential for recurrence or regeneration of the residual tissue, we recommend that not only complete resection of the IH should be performed during surgery, but also intraoperative pathological examination should be performed to ensure that the submicroscopic margin is negative. Wincheste et al [1] 39, F 5.0 Right (5) Discomfort, fullness N CA --Robinson [2] 58 M 3.0 Right (3) No symptoms N CA --Hashimoto et al [3] 32, M 1.2 Left (6) No symptoms N VH N (24 mo) -Dzian and Hamzík [4] 36, M 9.5 Left (7-8) Pain Unclear VH N (10 mo) -Dantis et al [5] 18, M 6.0 Left (7) Swelling, pain Y CA N (12 mo) -Ulku et al [6] 11, F 8.5 Right (9-11) Unclear N CA N (6 mo) -Saldanha et al [7] 34, F 3.0 Left (3) Unclear Unclear CA N (12 mo) -Elbawab etal [8] 14, M 6.0 Right (5) No symptoms Y Hemangioma N (6 mo) -Agarwal et al [9] 44, F Unclear Right (3) No symptoms N Hemangioma N (18 mo) -Mei et al [10] 14, F 7.0 Right (4) Pain, hemoptysis Y Hemangioma N (10 mo) Trauma Aguilo et al [11] 23, F 5.0 Left (7) No symptoms N AVH -Subdural AVM Kara et al [12] 46, M 4.0 Right (2) No symptoms N AVH N (48 mo) -Yuan et al [13] 44, F Unclear Left (2) No symptoms N CA + CH N (36 mo) -Ono et al [14] 33, M 9.5 Right (3)(4)(5) No symptoms N SVIH + LVIH N (36 mo) -Ali et al [15] 22, F 7.0 Left (6)(7)(8)(9) No symptoms Unclear CA + CH N (6 mo) -Yonehara et al [16] 33, M 5.0 Left (6) No symptoms Y SVIH N (60 mo) Trauma Kubo et al [17] 27, M 5.5 Right (7) Pain, exertional dyspnea N LVIH N (6 mo) -Ochi et al [18] 17…”

“…We searched the English literature relating to IH between January 1990 and September 2023 and identified 18 case reports. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Our present case represents the 19th case (Table 1). By reading these reports, we found no difference in the prevalence of IH between men and women, and most were young patients without chest symptoms; 2 patients had a history of trauma; 1 patient had other vascular lesions, and more than half of the lesions originated from the intercostal muscles and some patients had rib destruction.…”

Diagnosis and management of intercostal intramuscular hemangioma: an updated review

“…IMH is frequently found in the muscles of the upper and lower extremities; intercostal IMH represents 1.2–1.4% of all IMH diagnoses [ 2 , 3 ]. We identified 8 published articles in which patients were pathologically diagnosed with either intercostal IMH or hemangioma originating in the intercostal muscle (Table 1 ) [ 5 – 12 ]. In these articles, the mean age at surgery was 27.6 years (range, 11–46 years), and there were only 2 female patients.…”