Presentation
Progressive painless swelling of the anterior aspect of the right lower thigh.
Patient Data
There is a well-defined deep soft tissue swelling of the anterior aspect of the lower thigh with no calcification or cortical erosion of the femoral bone.
The ultrasound images demonstrate a fusiform heterogeneously hypoechoic lesion within the vastus medialis muscle with cystic areas representing blood-filled cavities. No calcification (phleboliths) seen within the lesion. On color Doppler (not shown) it appears a highly vascularized lesion.
There is a relatively well-circumscribed lobulated lesion centered on the vastus medialis muscle, isointense to the muscles on T1WI, hyperintense on T2WI, and STIR with areas of high signal on T1WI, low signal on T2W, and STIR (hemorrhagic areas) and peripheral rim of fatty signal well-visualized on T1WI sequences. The postcontrast sequences show a prominent enhancement.
Case Discussion
Case with characteristic features of a soft tissue hemangioma of intramuscular location.
Additional contributor: ZE. Boudiaf, MD