A Case Report of an Unusual Case of Cavernous Hemangioma at Retrocalcaneum Region.

Introduction: Subcutaneous hemangioma is a rare variant of slow-flowing venous malformation. It occurs in both adults and children and is more common in women. It exhibits an aggressive growth pattern, can occur anywhere in the body, and may recur after resection. This report shows a rare localization of hemangioma in the retrocalcaneal bursa.

Case Report: A female patient, age 31, presented with swelling and pain over the retro calcaneum region for 1 year. The pain in the retrocalcaneal region has increased with gradual intensity over the past 6 months. The swelling she described to be insidious in onset and gradually progressive. Examination findings at presentation were a middle-aged female with diffuse swelling in the retrocalcaneal region with a size of 2 cm by 1.5 cm. Based on the X-ray, we defined it to be myositis ossificans. With this view in mind, we admitted the patient and surgically excised the area. We operated by posteromedial approach and sent the specimen for histopathology. Pathology revealed calcified bursa. Microscopically, it was hemangioma with phleboliths and osseous metaplasia. The post-operative period was uneventful. The patient's pain was reduced, and overall performance was good at follow-up.

Conclusion: This case report highlights the importance for surgeons, pathologist to consider cavernous hemangioma as a differential diagnosis for retrocalcaneal swellings.