A 10-year-old female had complained of pain in the left thigh since she was 6-year-old. She had no significant prior medical or surgical history. Both axial T2-weighted Magnetic resonance imaging (MRI) and coronal fat-saturated enhanced T1-weighted MRI revealed heterogenous hyperintense within the skeletal muscle (Fig. a, b). The clinical diagnosis was VM. Restriction of the knee joint gradually appeared. Although sclerotherapy was attempted, no benefit was obtained. Additional ultrasonographic examination imaging showed an ill-defined hyperechoic intramuscular solid mass. Needle biopsy was performed, and VM was diagnosed. Then, surgical resection was performed.
A 53-year-old female had complained of pain and knee restriction after surgical treatment of a knee tumor at the age of 31. The details of surgical treatment were unclear. Axial T1-weighted MRI revealed low signal with fat component and sagittal fat-saturated T2-weighted MRI revealed high signal intensity (Fig. e, f). Under the clinical diagnosis of atypical lipomatous tumor or high grade liposarcoma, needle biopsy was performed, and the diagnosis of angiomatosis was made. Then, surgical resection was performed. After the resection, knee restriction disappeared.