Uncommon Case of Intramuscular Venous Malformation in the Subscapularis Muscle Mimicking Traumatic Brachial Plexopathy
By
Jin Hang Loh
Zhun Shen Tan
Elaine Zi Fan Soh
Chia Hua Lim
Muhammad Shafiq Azhar
Jamari Sapuan
Shalimar Abdullah
September 9, 2026
Clinical Report: Intramuscular Venous Malformation Mimicking Brachial Plexopathy
Background Intramuscular venous malformations (VMs) are rare vascular anomalies that can lead to significant clinical complications, including compressive neuropathies. Their presentation can mimic more common conditions, such as traumatic brachial plexopathy.
Data Highlights Clinical Event Details Initial Presentation Progressive weakness and numbness in right upper limb after occupational fall MRI Findings Lobulated lesion in right subscapularis muscle, measuring 3.7 cm × 6.0 cm × 8.3 cm Treatment Fluoroscopy-guided percutaneous bleomycin sclerotherapy Outcome Marked neurological recovery following treatment
Key Findings An intramuscular venous malformation was identified in the right subscapularis muscle. The VM caused compressive brachial plexopathy, initially misdiagnosed as traumatic injury. Magnetic resonance imaging (MRI) was crucial in diagnosing the VM and assessing its relationship to the brachial plexus. Fluoroscopy-guided percutaneous bleomycin sclerotherapy was successfully used as a treatment option. Post-treatment, the patient experienced significant neurological recovery alongside rehabilitation efforts. Clinical Implications Accurate imaging, particularly MRI, is essential for diagnosing vascular malformations that may mimic traumatic injuries.
Conclusion This case highlights the recognition of intramuscular venous malformations as potential causes of brachial plexopathy.
Related Resources & Content
International Society for the Study of Vascular Anomalies, ISSVA, 2025 -- Classification of Vascular Anomalies Frontiers in Medicine, 2026 -- Case Report: A Rare Mimicker of Traumatic Brachial Plexopathy RadiologyInfo.org -- Vascular Malformations PubMed, 2025 -- MR Imaging of the Brachial Plexus: A Practical Review European Radiology — Key Stabilizers of the Posteromedial and Posterolateral Knee: Anatomy, Ultrasound Techniques, and Findings in Anterior Cruciate Ligament Tear Cases Frontiers in Medicine — Ultrasound-guided hydrodissection of the subclavius muscle region in neurogenic thoracic outlet syndrome: a case report Knee Surgery, Sports Traumatology, Arthroscopy — Connection between subscapularis tears and biceps pulley injuries Archives of Orthopaedic and Trauma Surgery — Emergency access to the subclavian vessels by non-thoracic surgeons: a cadaver-based learning model for orthopedic trauma surgery Frontiers in Medicine -- Ultrasound-guided hydrodissection of the subclavius muscle region ScienceDirect -- Magnetic Resonance Neurography: part 1 Classification | International Society for the Study of Vascular Anomalies Frontiers | Case Report: A Rare Mimicker of Traumatic Brachial Plexopathy: Intramuscular Venous Malformation of the Subscapularis Muscle Vascular Malformations MR Imaging of the Brachial Plexus: A Practical Review. Safety Profile of Sclerosing Agents in the Management of Low‐Flow Vascular Malformations of the Head and Neck—A Systematic Review - PMC GLOBAL VARIABILITY IN SCLEROTHERAPY FOR SLOW-FLOW VASCULAR MALFORMATIONS: A SURVEY TO INFORM CONSENSUS DEVELOPMENT - ScienceDirect Clinical significance of the persistance of localized intravascular coagulopathy in venous malformation - ScienceDirect TEK-Related Venous Malformations - GeneReviews® - NCBI Bookshelf
