Posttraumatic Arteriovenous Hemangioma of the Hypothenar Eminence in a Car Mechanic
- Affiliations
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- 1Department of Orthopedic Surgery, College of Medicine, Jeju National University, Jeju, Korea. cbnuoskbs@jejunu.ac.kr
- KMID: 1424100
- DOI: http://doi.org/10.4055/jkoa.2013.48.2.118
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.
Figure
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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).
Reference
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