Presentation
Painless swelling of the left shoulder.
Patient Data
Well-circumscribed lobulated intramuscular soft tissue mass centered on the teres minor and extending to the infraspinatus muscle. It appears isointense to muscles on T2, very high signal on PD fat sat, containing foci of low signal well-demonstrated on GE sequence (most likely phleboliths). The postcontrast dynamic sequences show a progressive enhancement with almost fill-in on delayed sequences. There is an extension around the lateral border of the scapula with no involvement of the subscapularis muscle.
Case Discussion
MRI features most consistent with intramuscular hemangioma within the teres minor, extending to the infraspinatus muscle and around the lateral border of the scapula.
Intramuscular hemangiomas are rare benign vascular channels within skeletal muscle. Usually seen in young adults and adolescents and most are thought to be congenital.
Intramuscular hemangiomas refer to the provisionally unclassified vascular anomalies category, which is distinct from venous malformations (VM), arteriovenous malformations (AVM). Please refer to the ISSVA classification of vascular anomalies (2018).
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