Posttraumatic Arteriovenous Hemangioma of the Hypothenar Eminence in a Car Mechanic

Kwang Woo Nam; Sang Min Kang; Sung Jin Shin; Kyu Bum Seo

doi:10.4055/jkoa.2013.48.2.118

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Nam, Kang, Shin, and Seo: Posttraumatic Arteriovenous Hemangioma of the Hypothenar Eminence in a Car Mechanic

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(2): 118-123.

Published online: 25 April 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.2.118

Posttraumatic Arteriovenous Hemangioma of the Hypothenar Eminence in a Car Mechanic

Kwang Woo Nam, M.D., Sang Min Kang, M.D., Sung Jin Shin, M.D., Kyu Bum Seo, M.D.

Department of Orthopedic Surgery, College of Medicine, Jeju National University, Jeju, Korea.

Correspondence to: Kyu Bum Seo, M.D. Department of Orthopedic Surgery, Jeju National University Hospital, 15 Aran 13-gil, Jeju 690-767, Korea. TEL: +82-64-717-1690, FAX: +82-64-717-1131, cbnuoskbs@jejunu.ac.kr

Received 10 April 2012 Revised 18 August 2012 Accepted 4 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Arteriovenous hemangiomas are found mainly in the limbs and scalp, and are common in women and children. However, there have been very limited reports concerning posttraumatic arteriovenous hemangioma, and none was reported in the medical literature regarding posttraumatic arteriovenous hemangioma of hypothenar eminence causing neurologic symptoms. We report a case of arteriovenous hemangioma of hypothenar eminence after recurrent trauma that was successfully treated by an excision of the mass and vein graft.

Keywords: hypothenar eminence, posttraumatic arteriovenous hemangioma

Figures and Tables

Figure 1

Clinical photograph shows an enlarged mass of the hypothenar eminence of the left hand.

Figure 2

Color Doppler sonographic image showed a vascular mass including arterial blood flow of ulnar artery in the region of the hypothenar eminence (white arrow: ulnar artery).

Figure 3

(A, B) Coronal T1 and T2-weighted magnetic resonance images show that homogeneous low signal intensity in hypothenar eminence of the left hand on T1-weighted image, which is converted to heterogenous high signal intensity at T2-weighted image. (C) Coronal T1-weighted enhanced magnetic resonance image shows well-defined enhancement and septum-like structures with low signal intensity of the hypothenar eminence. Magnetic resonance images show a vascular mass that is lobulated in the region of the hypothenar mass.

Figure 4

Intraoperative photograph showed a mass originated from the ulnar artery and compressed the ulnar nerve (white arrows: ulnar artery, right angled arrow: ulnar nerve).

Figure 5

A 5×3 cm sized vascular mass was completely excised.

Figure 6

The deficit of the ulnar artery was grafted using dorsal metacarpal vein of the ipsilateral hand.

Figure 7

(A) Photomicrograph shows that the lesion is composed of an overgrowth of crowded blood vessels of various size and shape (H&E stain, ×10). (B) Elastic laminae and fibers (white arrow) in the arteries are clearly demonstrated (van Gieson stain, ×100).

Figure 8

Axial computed tomographic image obtained four months after surgery demonstrates complete removal of the lesion without regrowth and no abnormal blood flow of ulnar artery in the region of the hypothenar eminence (white arrow).

Table 1

Classification of Vascular Anomalies

RICH, rapidly involuting congenital hemangioma; NICH, noninvoluting congenital hemangioma.

References

1. Nazzi V, Messina G, Dones I, Ferroli P, Broggi G. Surgical removal of intramuscular arteriovenous hemangioma of the upper left forearm compressing radial nerve branches. J Neurosurg. 2008. 108:808–811.

2. Pulidori M, Capuano C, Mouchaty H, Cioffi F, Di Lorenzo N. Intramuscular thrombosed arteriovenous hemangioma of the upper right arm mimicking a neuroma of the ulnar nerve: case report. Neurosurgery. 2004. 54:770–771.

3. Acharya G, Merritt WH, Theogaraj SD. Hemangioendotheliomas of the hand: case reports. J Hand Surg Am. 1980. 5:181–182.

4. Enzinger FM, Weiss SW. Soft tissue tumors. 2001. 4th ed. St Louis: Mosby;837–887.

5. Legiehn GM, Heran MK. Venous malformations: classification, development, diagnosis, and interventional radiologic management. Radiol Clin North Am. 2008. 46:545–597.

6. Allen PW, Enzinger FM. Hemangioma of skeletal muscle. An analysis of 89 cases. Cancer. 1972. 29:8–22.

7. Cohen JM, Weinreb JC, Redman HC. Arteriovenous malformations of the extremities: MR imaging. Radiology. 1986. 158:475–479.

8. Perumal V, Francisco CJ. Arteriovenous hemangioma of the foot--a case report. Foot Ankle Surg. 2010. 16:e61–e62.

9. Pollard MA. Vascular tumors of the hand: a report of 3 cases. Hosp Physician. 2003. 3:57–61.

10. Hiroyasu N, Yukio S, Masayoshi U, Masahide I, Mitsunori O, Ryoji U. A case with arteriovenous hemangioma that occurred in the finger. Okinawa Med J. 2003. 41:62–64.

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