Presentation
Swelling over left calf since 2 years. No pain.
Patient Data
There is well circumscribed hypoechoic lesion noted in the deep subcutaneous plane. Internal vascularity also seen.
MR subcutaneous marker is seen at the lower third of the lateral leg.
There is a well-defined, lobulated cystic focus noted in the deep subcutaneous plane, of lateral lower 3rd leg. It shows few hypointense foci and septae within. There is a superficial blood vessel(likely venous) noted to course along the superomedial margin of the lesion. Post contrast images shows intense enhancement.
Adjacent moderate subcutaneous edema was seen.
No breach into the underlying muscular plane.
Case Discussion
This is a case of deep subcutaneous plane soft tissue venous hemangioma.
The primary role of the radiologist is to rule out other possibilities of vascular tumors or sarcomas, to avoid uncalled biopsy or surgical intervention.
Usually, soft tissue hemangiomas are not invasive in appearance. However, in deep-seated hemangiomas, the possibilities of bone changes such as cortical thickening, trabecular hypertrophy or medullary sclerosis should be sought for.
Special thanks: Dr Nanda Kumar.
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