INFANTILE INTRAMUSCULAR HEMANGIOMA OF THE FOREARM: CASE REPORT

The objective of this case report is to emphasize the fact that the intramuscular hemangiomas (IMH) in infants present a significant challenge for the orthopedic surgeon. Due to their rapid growth, IMH can easily be misinterpreted as malignancies. In such cases, MRI is a valuable diagnostic tool. We report a case of a six-month-old female infant with a large, oval-shaped swelling, localized on the dorsal aspect of the left forearm. In addition, the inability to fully extend the wrist and fingers of the left hand was evident. MRI, magnetic angiography and Doppler flow ultrasonography were used as diagnostic tools, revealing a large lobulated lesion with well-defined edges on the dorsal aspect of the forearm between the extensors of the wrist and fingers, with extension in the interosseous membrane between radius and ulna. A surgical resection of the tumor was performed. Histologic findings were consistent with those of an infantile hemangioma. Six weeks after surgery, full recovery of wrist and finger extension was evident. Finally, at five years of follow-up, there was no recurrence of the vascular tumor and normal upper limb function was maintained. Surgical resection of the IMHs in the upper limbs must be cautious and meticulous. The loss of an adjacent muscle or nerve injury from aggressive surgical resection can result in functional impairment of the limb.