An uncommon ethiology of equinizm: intramusculer hemangioma (case report)

Intramuscular hemangioma is an uncommon benign lesion and contributes % 0.8 of all hemangiomas. Diagnosis can only be done with histopathological evaluation in this type of tumor which presents clinically with pain, swelling and restriction of movements depending on its anatomical localization. 13 year old boy was admitted to the hospital with a history of pain, swelling in his right calf, presenting for the last five years. His major complaint was clinically increasing unilateral toe-walking. After having done the radiological evaluation, the diagnosis of intramuscular hemangioma was verified with tru-cut biopsy. This benign tumor caused contracture of the gastrocnemius muscle and lead to unilateral secondary equinism deformity of the foot. Tumor was excised by radical surgery. The gastrocnemius muscle was lengthened by the Vulpius procedure. No local recurrence was observed in the three year follow up. The patient had a normal gait pattern in his last follow up physical examination. We wanted to share our experience with this unique tumor presenting with unique symptoms.

Ekinizmin sýk rastlanmayan etyolojisi: Intramusküler hemanjiom (Olgu sunumu)

Intramusküler hemanjiom sýk rastlanmayan benign bir lezyon olup, tüm hemanjiomlarýn % 0,8’ ini oluþturur. Klinik þikayet olarak anatomik lokalizasyonuna göre aðrý, þiþlik ve hareket kýsýtlýlýðý görülebilir ancak kesin taný için histopatolojik deðerlendirme gerekir. 13 yaþýnda erkek çocuðu hastanemize, sað baldýrýnda son 5 yýldýr aðrý ve þiþlik þikayetiyle baþvurdu. Hastanýn en belirgin þikayeti ise giderek daha da belirgin hale gelen tek taraflý parmak ucunda yürüme idi. Radyolojik deðerlendirmeler sonrasýnda konulan intramusküler hemanjiom tanýsý, tru-cut biyopsi ile doðrulandý. Tümörün gastrokinemius kasýnda kontraktüre neden olduðu ve bu sebeple sekonder düþük ayak deformitesi geliþmiþ olduðu görüldü. Tümör radikal cerrahi ile eksize edildi. Gastrokinemius kasý Vulpius prosedürü ile uzatýldý. 3 yýllýk takipte lokal rekürrens bulgusu saptanmadý. Son yapýlan klinik kontrolünde hastanýn normal yürüyüþ paternine kavuþmuþ olduðu görüldü. Yazýmýzda nadir görülen bu tümör ve klinik bulgusu ile ilgili klinik tecrübemizi paylaþmak istedik.