A rare case of pyomyositis with intramuscular hemangioma in the upper arm

Intramuscular hemangiomas are rare in musculoskeletal pain differentials, especially in the upper extremities. We report a case of a 56-year-old male with an intramuscular hemangioma and abscess in the biceps brachii, presenting with pain, swelling, and limited elbow movement. High C-reactive protein (25.43 mg/dL) and visual analog scale score of 10 were noted. Radiograph showed 3 phleboliths. MRI revealed an enhancing lesion (2.5×2.7×9.8 cm) and abscess. We performed surgery for excision of the intramuscular hemangioma and drainage of the abscess in the biceps muscle. By 5 weeks post-surgery, all functional limitations had resolved, and no recurrence was observed at the 5-month follow-up.