Large Cavernous Hemangioma of the Subscapularis Muscle: A Case Report

Lee,  Ki Won; Lee,  Hyun Il; Kim,  Chung Hwan; Kim,  Tae Kyung

doi:2014.17.4.185

Clin Shoulder Elb > Volume 17(4); 2014 > Article

Case Report

Clinics in Shoulder and Elbow 2014;17(4):185-189.
DOI: https://doi.org/10.5397/CiSE.2014.17.4.185 Published online December 31, 2014.

Large Cavernous Hemangioma of the Subscapularis Muscle: A Case Report

Ki Won Lee, Hyun Il Lee, Chung Hwan Kim, Tae Kyung Kim

Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. hyunil.lee7@gmail.com

Received: 21 March 2014 • Revised: 14 May 2014 • Accepted: 22 June 2014

Abstract

We report a case of intramuscular hemangioma in the subscapularis muscle and the resulting impairment of shoulder function in an adult patient. A nineteen-year-old female complained of shoulder pain and the development of a mass in the absence of previous trauma. Physical examinations, including lift-off and belly-press tests, showed abnormality. X-ray showed multiple calcifications in the front of the scapula. Magnetic resonance imaging showed a soft-tissue mass occupying almost the entire intramuscular portion of the subscapularis muscle. An arthroscopic examination excluded the possibility of a joint invasion, after which the entire mass was successfully removed by open excision. The displacement of the subscapularis by the mass was relieved after the surgery. Pathological diagnosis of the tissue confirmed a cavernous hemangioma. Both shoulder pain and function was improved after operation. There was no evidence of recurrence even at the 2-year follow-up. Rare forms of hemangioma adjacent to the shoulder joint could be successfully managed with surgical excision. Differential diagnosis, such as synovial chondromatosis, pigmented villonodular synovitis, and malignant sarcoma, should also be considered.

Key Words: Shoulder; Rotator cuff; Hemangioma