Deceptive Mass - Intramuscular Hemangioma in the Chest Wall: A Case Report

Intramuscular hemangiomas (IMHs) are rare, benign vascular tumours accounting for less than 1% of all hemangiomas. Chest wall IMHs are even rarer. Here, we report a case of a 16-year-old male who presented with a progressively enlarging, painless mass in the left lateral chest wall, first noted four years earlier. MRI revealed a lobulated, irregular lesion involving subcutaneous tissue and adjacent muscles. Surgical excision via small lateral incision was performed, removing the lesion entirely along with a margin of normal muscle. The feeding vessels were dissected and ligated using Trutie titanium clips and the diffuse ooze was managed with oxidised regenerated cellulose Clinicel Fibrillar (Healthium Medtech, India) and the skin was closed in layers using triclosan coated polyglactin 910 Trusynth Plus Neo suture. Histopathological analysis confirmed intramuscular cavernous hemangioma without atypia or mitosis. The patient recovered uneventfully and was discharged three days post-surgery. This case highlights the importance of accurate diagnosis and complete excision in managing rare chest wall hemangiomas.