Observation is appropriate for asymptomatic or mildly symptomatic hemangiomas of skeletal muscle and bone. If symptoms cannot be managed adequately by activity modification and nonnarcotic analgesics, further treatment may be considered.embolization may be used to provide symptomatic relief of intramuscular hemangiomas. When surgical excision is planned, embolization also may be used preoperatively to decrease intraoperative blood loss and postoperative recurrence.Excision of symptomatic intramuscular hemangiomas can provide permanent relief. However, because complete excision is required for long-lasting satisfactory results, this treatment option generally is restricted to hemangiomas contained within a single muscle belly. Even so, complete resection is not always possible; when incompletely resected, hemangiomas nearly always recur. In addition, surgery can be associated with large-volume blood loss, even when preoperative embolization is employed. Laser knife excision of hemangiomas is a technique developed to better control intraoperative bleeding. Preoperative ultrasound-guided hookwire localization may aid in defining the extent of a hemangioma during excision. Wang et al found it to be safe and effective for nonpalpable intramuscular hemangiomas and concluded that it may provide a better cosmetic result and improved functional recovery.Radiation has been used to treat soft-tissue hemangiomas in surgically inaccessible or potentially dangerous sites.