The first report of an intercostal hemangioma coexisting with multiple hepatic hemangiomas: a case report and review of the literature

Background: Intercostal hemangioma (IH) is an extremely rare disease, with only 17 cases reported over the past 30 years, and the case of IH coexisting with multiple hepatic hemangiomas (MHHs) has not been reported up to now. IHs appear to be more aggressive than hepatic hemangiomas and are difficult to distinguish from other intercostal tumors. Case presentation: we report the first case of an intercostal venous hemangioma (IVH) coexisting with MHHs. The patient was a 58-year-old male who came to our hospital due to long-term and repeated epigastric distention. Plain chest computed tomography (CT) scans revealed two adjacent masses protruding from the left chest wall into the thorax. The nature of the masses remained unclear after enhanced CT scans. We performed video-assisted thoracoscopic surgery to remove the masses. These masses were finally diagnosed as IVHs, based on surgical records, imaging, and pathological findings. In addition, plain abdominal CT scans also indicated the presence of MHHs, this diagnosis was consistent with the patient's two doppler ultrasound findings over the last two years. There was no significant change in the hepatic masses when examined at 32 months follow-up. Unfortunately, there was a recurrence of the left IH, and the 5th rib was slightly eroded and destroyed. This may have been related to the fact that we did not distinguish the nature of the masses before surgery and the incomplete removal of masses during surgery. Conclusions Early clinical intervention for IHs of the chest wall can prevent tumor growth and damage to adjacent structures. Preoperative imaging diagnosis is important. Hemangiomas have a high recurrence rate, Complete surgical resection is the common treatment, and chest wall reconstruction can be performed if necessary. The authors hope that our case analysis and literature review will help clinicians identify IVH as highly unusual.