1
|
Bleuze MM, Fricano E, Farrell JM, Brady JE. A calvarial osteolytic lesion of probable vascular origin in a Maya juvenile from the Classic Period ( 250-900 CE). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2024; 46:9-15. [PMID: 38865934 DOI: 10.1016/j.ijpp.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/26/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE This case study evaluates a focal osteolytic lesion in the right sulcus sinus transversi of an isolated os occipitale. MATERIALS The os occipitale is from a juvenile from the Cueva de Sangre at the Classic Period (250-900 CE) site of Dos Pilas, Guatemala METHODS: The lesion was examined macroscopically, microscopically, and radiographically. RESULTS The oval lesion has a well-circumscribed margin, endocranial origin, and involves cortical destruction of the inner and outer tables. Subperiosteal bone reaction around the lesion is present on the ectocranial surface. Skeletal evidence of increased vascularity, diploë expansion, and perimortem fracture near the lesion are not observed. CONCLUSIONS The lesion appears to reflect a response to the presence of an expansile process that has caused pressure erosion. The anatomical location of the lesion and the endocranial origin suggest a probable vascular anomaly, such as a vascular malformation. SIGNIFICANCE This case study represents one of the few bioarchaeological evaluations of probable vascular anomaly in a juvenile. As such, it expands our knowledge about vascular anomalies in the past and provides a comparative and core reference for guiding future paleopathological investigations on cranial osteolytic lesions. LIMITATIONS The skeletal assemblage is commingled and fragmentary preventing the assessment of the distribution of lesions across the skeleton. SUGGESTIONS FOR FUTURE RESEARCH Further scrutiny of bioarchaeological collections is needed to better understand the distribution of vascular anomalies in the past.
Collapse
Affiliation(s)
- Michele M Bleuze
- Department of Anthropology, California State University, 5151 State University Drive, Los Angeles, CA 90032, USA.
| | - Ellen Fricano
- Medical Anatomical Sciences, Western University of Health Sciences, 309 E Second St, Pomona, CA 91766, USA
| | - Jessica M Farrell
- Affiliated Pathologists of the Central Coast (APCC), P.O. Box 5007, San Luis Obispo, CA 93403, USA
| | - James E Brady
- Department of Anthropology, California State University, 5151 State University Drive, Los Angeles, CA 90032, USA
| |
Collapse
|
2
|
Tan GZL, Leow L, Kuek BJW, Mok Y. Locally Aggressive Rib Hemangioma With Glomeruloid and Papillary Features - Expanding the Clinicopathologic spectrum of Bone Hemangiomas. Int J Surg Pathol 2024; 32:1154-1157. [PMID: 38062642 DOI: 10.1177/10668969231213984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Intra-osseous hemangiomas are uncommon tumors that can present diagnostic and treatment dilemmas. Bone hemangiomas with papillary and glomeruloid growth patterns are exceptionally rare. We present an example of an intra-osseous hemangioma of the rib displaying aggressive features on both radiology and histology. Morphologically, prominent papillary and glomeruloid architectural patterns were observed, in addition to features of cavernous and capillary hemangiomas. Extensive extra-osseous soft tissue involvement was seen. Awareness of the diverse histological features and locally aggressive behavior of bone hemangiomas is important in avoiding over-interpretation as a malignant lesion.
Collapse
Affiliation(s)
- Gideon Ze Lin Tan
- Department of Pathology, National University Health System, Singapore
| | - Lowell Leow
- Thoracic Surgery, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore
| | - Benjamin Jia Wei Kuek
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Yingting Mok
- Department of Pathology, National University Health System, Singapore
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
3
|
Dong A, Nian S, Bai Y, Zuo C. Hemangioma of the Ilium Simulating Bone Metastasis on 18 F-PSMA-1007 PET/CT. Clin Nucl Med 2024; 49:e304-e306. [PMID: 38377381 DOI: 10.1097/rlu.0000000000005076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT A 64-year-old man was referred for 18 F-PSMA-1007 PET/CT scan for initial staging of biopsy-proved prostate adenocarcinoma. 18 F-PSMA-1007 PET/CT showed focal intense 18 F-PSMA-1007 of the prostate adenocarcinoma and a focal intense activity with SUV max of 10.5 in the left ilium. The 18 F-PSMA-1007-avid iliac bone lesion corresponded to a hemangioma, which was initially detected on pelvic MRI 13 months ago and remained stable in size. This case indicates that hemangioma should be included in the differential diagnosis of PSMA-avid iliac bone lesions.
Collapse
Affiliation(s)
| | - Shensheng Nian
- Orthopedics, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yushu Bai
- Orthopedics, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | | |
Collapse
|
4
|
Tortorelli I, Bellan E, Chiusole B, Murtas F, Ruggieri P, Pala E, Cerchiaro M, Buzzaccarini MS, Scarzello G, Krengli M, Bisinella G, Battisti S, Di Maggio A, Zagonel V, Tos APD, Sbaraglia M, Brunello A. Primary vascular tumors of bone: A comprehensive literature review on classification, diagnosis and treatment. Crit Rev Oncol Hematol 2024; 195:104268. [PMID: 38237880 DOI: 10.1016/j.critrevonc.2024.104268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/23/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
Primary vascular tumors of bone are a heterogeneous group of neoplasms, ranging from benign hemangiomas to frankly malignant epithelioid hemangioendotheliomas and angiosarcomas. Over the years, their classification has been a matter of discussion, due to morphologic similarities and uncertainty regarding biologic behavior. Over the past decade, with the development of next-generation sequencing, there has been a significant improvement in the molecular characterization of these lesions. The integration of their morphologic, immunohistochemical and molecular features has led to a better stratification, with important prognostic and therapeutic implications. Nevertheless, primary vascular bone tumors still represent a challenge for medical oncologists. Given their rarity and heterogeneity, in the last few years, there has been no significant progress in medical treatment options, so further research is needed. Here we present a review of the current knowledge regarding primary vascular tumors of the bone, correlating clinicopathologic features with tumor behavior and therapeutic approaches.
Collapse
Affiliation(s)
- Ilaria Tortorelli
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Elena Bellan
- Department of Pathology, Azienda Ospedale Università Padova, Via Gabelli 61, 35121 Padua, Italy
| | - Benedetta Chiusole
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Fabio Murtas
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Via Nicolò Giustiniani 1, 35128 Padua, Italy
| | - Elisa Pala
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Via Nicolò Giustiniani 1, 35128 Padua, Italy
| | - Mariachiara Cerchiaro
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Via Nicolò Giustiniani 1, 35128 Padua, Italy
| | | | - Giovanni Scarzello
- Radiotherapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Marco Krengli
- Radiotherapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Nicolò Giustiniani 2, 35128 Padua, Italy
| | - Gianluca Bisinella
- Division of Orthopedics and Trauma, AULSS 6 Euganea, Ospedali Riuniti Padova Sud, Via Albere 30, Monselice, Padua, Italy
| | - Sara Battisti
- Division of Orthopedics and Trauma, AULSS 6 Euganea, Ospedali Riuniti Padova Sud, Via Albere 30, Monselice, Padua, Italy
| | - Antonio Di Maggio
- Oncologic Radiology Unit, Department of Radiology and Medical Physics, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Vittorina Zagonel
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedale Università Padova, Via Gabelli 61, 35121 Padua, Italy; Department of Medicine, University of Padua School of Medicine, Via 8 Febbraio 2, 35122 Padua, Italy
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedale Università Padova, Via Gabelli 61, 35121 Padua, Italy; Department of Medicine, University of Padua School of Medicine, Via 8 Febbraio 2, 35122 Padua, Italy
| | - Antonella Brunello
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
| |
Collapse
|
5
|
Oh J, Han SI, Lim SC. Intraosseous hemangioma with aneurysmal bone cyst-like changes of the hyoid bone: Case report and literature review. Medicine (Baltimore) 2024; 103:e37137. [PMID: 38335421 PMCID: PMC10860961 DOI: 10.1097/md.0000000000037137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
RATIONALE Intraosseous hemangioma is a rare benign vascular tumor of the bone that can affect any body part; however, the most common site is the vertebra, followed by calvarial bones. PATIENT CONCERNS We present a case of intraosseous hemangioma in a 23-year-old male who presented a feeling of fullness in the throat for 3 months. The hyoid bone level had a hard mass of about 5 cm. Fine needle aspiration showed 5 mL dark bloody aspirates. Magnetic resonance image showed a 5.3 cm mixed signal intensity lesion in the hyoid body. DIAGNOSIS Histopathologic examination showed intraosseous hemangioma with aneurysmal bone cyst (ABC)-like changes in the hyoid bone. INTERVENTIONS The mass was completely removed without significant problems. OUTCOMES Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed. LESSONS The authors experienced a case of intraosseous hemangioma with ABC-like changes. There has been no case report of intraosseous hemangioma in the hyoid bone. This case showed a spectral pattern of the ABC-like changes developing from the underlying bone tumor as a secondary change. ABC-like changes in bone tumors can mislead the diagnosis. Careful examination of the tumor is essential for the correct diagnosis of ABC or ABC-like changes.
Collapse
Affiliation(s)
- Jeonghyun Oh
- Department of Otorhinolaryngology, Chosun University, Gwangju, Korea
| | - Song Iy Han
- Division of Premedical Science, Chosun University, Gwangju, Korea
| | - Sung-Chul Lim
- Department of Pathology, College of Medicine, Chosun University, Gwangju, Korea
| |
Collapse
|
6
|
Errani C, De Benedictis I, Righi A, Valenti B, Del Savio E, Baldazzi D, Benini S, Sbaraglia M, Vega Jimenez B, Vanel D, Donati DM, Dei Tos AP, Maestro R. Fusion transcriptome profiling defines the monoclonal origin of multifocal epithelioid haemangioma of bone. Histopathology 2023; 83:743-755. [PMID: 37519041 DOI: 10.1111/his.15016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
AIMS Epithelioid haemangioma (EH) of bone remains a highly controversial entity. Indeed, the WHO classifies EHs of soft tissues as benign tumours, whereas bone EHs are considered intermediate-locally aggressive tumours due to common multifocal presentation and local destructive growth. To gain insights into the clinical behaviour and biology of EH of bone we retrospectively analysed 42 patients treated in a single institution from 1978 to 2021. METHODS AND RESULTS Multifocal presentation was detected in 17 of 42 patients (40%) primarily as synchronous lesions. Patients were treated with curettage (57%), resection (29%) or biopsy, followed by radiotherapy or embolisation (14%). Follow-up (minimum 24 months) was available for 38 patients, with only five local recurrences (13%) and no death of disease. To clarify whether the synchronous bone lesions in multifocal EH represent multicentric disease or clonal dissemination, four cases were profiled by RNA-sequencing. Separate lesions from the same patient, which showed a similar transcriptional profile, expressed the same fusion transcript (involving FOS or FOSB) with identical gene breakpoints. CONCLUSIONS These results indicate that, in EH of bone, multifocal lesions are clonally related and therefore represent the spread of a same neoplastic clone rather than simultaneous independent tumours. This finding is in apparent contradiction with the benign clinical course of the disease, and suggests that tumour dissemination in bone EH probably reflects a phenomenon of passive spreading, with tumour cells colonising distal sites while maintaining their benign biological nature.
Collapse
Affiliation(s)
- Costantino Errani
- Clinica Ortopedica e Traumatologica III a Prevalente Indirizzo Oncologico, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Ilaria De Benedictis
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, Aviano, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Beatrice Valenti
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, Aviano, Italy
| | - Elisa Del Savio
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, Aviano, Italy
| | - Davide Baldazzi
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, Aviano, Italy
| | - Stefania Benini
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedaliera Universitaria di Padova, Padua, Italy
- Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | | | - Daniel Vanel
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Davide Maria Donati
- Clinica Ortopedica e Traumatologica III a Prevalente Indirizzo Oncologico, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedaliera Universitaria di Padova, Padua, Italy
- Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Roberta Maestro
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, Aviano, Italy
| |
Collapse
|
7
|
Powell GM, Littrell LA, Broski SM, Inwards CY, Wenger DE. Imaging features of intraosseous hemangiomas: beyond the mobile spine and calvarium. Skeletal Radiol 2023; 52:1739-1746. [PMID: 37052653 DOI: 10.1007/s00256-023-04339-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Describe imaging features of intraosseous hemangiomas located outside of the mobile spine and calvarium. MATERIALS AND METHODS Imaging and medical records were retrospectively reviewed for cases of intraosseous hemangiomas located outside of the calvarium and mobile spine. Evaluation included patient demographics, histologic confirmation, and imaging characteristics. RESULTS Thirty-six patients were included (25 F, 11 M; mean age 54 ± 17 years, range 10-84 years) with 37 total lesions (70% axial and 30% appendicular skeleton). Mixed lytic and sclerotic features were identified on 83-85% radiographs and CTs. Amorphous increased density mimicking osteoid matrix was present on 38-45% radiographs and CTs. Classic honeycomb or radial pattern was identified on 45% of CTs. Osseous expansion and cortical permeation were common features. CT identified periosteal reaction in 24% of lesions. All hemangiomas had heterogeneous MRI signal and most moderately or avidly enhanced. Intralesional fat was identified on 78% MRIs, often as a minor component and only detected on 24% of CTs. A soft tissue mass was present on 52% of MRIs. FDG PET/CT mean SUVmax of 3.2 ± 0.6 (range 1.9-5.0). Lesional FDG activity relative to background marrow was increased in 75% of lesions. Lesions with cortical permeation had higher metabolic activity versus those without (3.5 ± 0.7 versus 2.2 ± 0.3, p = 0.041). CONCLUSION Intraosseous hemangiomas outside of the mobile spine and calvarium demonstrate more aggressive imaging features compared to vertebral hemangiomas, including cortical permeation, soft tissue mass, amorphous increased density mimicking osteoid matrix, and increased FDG activity.
Collapse
Affiliation(s)
- G M Powell
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - L A Littrell
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - S M Broski
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - C Y Inwards
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - D E Wenger
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| |
Collapse
|
8
|
A case of restitution ad integrum in Gorham-Stout disease. Joint Bone Spine 2023; 90:105478. [PMID: 36332892 DOI: 10.1016/j.jbspin.2022.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/26/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Abstract
Gorham-Stout disease (or "vanishing bone" disease) is a rare mono or polyostotic disease of unknown etiology, characterized by intraosseous angiomatous proliferation leading to bone resorption. We report the case of a 17-year-old woman presenting with symptomatic osteolytic lesions of the frontal vault. Imaging was suggestive of Gorham-Stout disease without argument for other diagnoses. An unusual evolution of the "vanishing bone" lesions was observed on the scan after one year, with a full recovery of the lytic lesions. This report shows for the first time a spontaneous restitutio ad integrum of bone matrix in Gorham-Stout disease.
Collapse
|
9
|
Haikal C, Beucler N, Fuentes S, Bouvier C, Le Corroller T. Intractable low-back pain in a patient with history of multiple neoplasms. Skeletal Radiol 2023; 52:137-139. [PMID: 35792955 DOI: 10.1007/s00256-022-04115-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Christelle Haikal
- Radiology Department, APHM, Hôpital Sainte-Marguerite, 270 Bd de Sainte-Marguerite, 13009, Marseille, France
| | - Nathan Beucler
- Neurosurgery Department, APHM, Hôpital La Timone, 13005, Marseille, France
| | - Stéphane Fuentes
- Neurosurgery Department, APHM, Hôpital La Timone, 13005, Marseille, France
| | - Corinne Bouvier
- Pathology Department, APHM, Hôpital La Timone, 13005, Marseille, France
| | - Thomas Le Corroller
- Radiology Department, APHM, Hôpital Sainte-Marguerite, 270 Bd de Sainte-Marguerite, 13009, Marseille, France. .,ISM UMR 7287, Aix Marseille University, CNRS, Marseille, France.
| |
Collapse
|
10
|
Yuen LC, Baker ML, Sin JM, Linos K, Kerr DA. A Rare Case of Primary Epithelioid Hemangioma of Bone with WWTR1::FOSB Fusion: A Benign Lesion with the Potential to Mimic Malignancy. Int J Surg Pathol 2022:10668969221117438. [PMID: 35946109 DOI: 10.1177/10668969221117438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Epithelioid hemangioma of bone is a rare benign, locally aggressive vascular tumor that can be particularly challenging to diagnose given its frequent multifocality, non-specific imaging findings, and wide range of morphologic appearances. Additionally, some epithelioid hemangiomas demonstrate atypical histologic features including increased cellularity, necrosis, and moderate cytologic atypia - characteristics that may raise concern for malignancy. Molecular studies can serve as a powerful, objective tool in the differential diagnosis of diagnostically challenging epithelioid vascular tumors. Importantly, FOS and FOSB gene rearrangements have been identified as the genetic hallmarks of osseous epithelioid hemangioma, present in greater than 70% of cases. FOSB-fusion-positive epithelioid hemangioma, in particular, may display atypical histologic features. While ZFP36 is the typical FOSB fusion partner in epithelioid hemangioma, we herein present a case of epithelioid hemangioma of bone with a rare WWTR1::FOSB fusion. This case demonstrates the diagnostic challenges associated with epithelioid hemangioma, especially in the setting of FOSB gene rearrangements, and the importance of genomic studies in the work up of these vascular tumors.
Collapse
Affiliation(s)
- Leslie C Yuen
- 12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Michael L Baker
- 12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA.,Department of Pathology and Laboratory Medicine, 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Jessica M Sin
- 12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA.,Department of Radiology, 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Konstantinos Linos
- 12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA.,Department of Pathology and Laboratory Medicine, 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Darcy A Kerr
- 12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA.,Department of Pathology and Laboratory Medicine, 22916Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| |
Collapse
|
11
|
Savvidou O, Korkolopoulou P, Lakiotaki E, Sioutis S, Vottis C, Gavriil P, Melissaridou D, Papagelopoulos P. Multifocal Epithelioid Hemangioma of bone: a rare vascular neoplasm. Clinicopathological diagnosis and treatment. A case report and literature review. J Long Term Eff Med Implants 2022; 32:47-55. [DOI: 10.1615/jlongtermeffmedimplants.2022041868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
12
|
Giampaoli G, Chirumbolo S, Di Ceglie P, Bertossi D, Nocini R. Frontal bone hyperostotic mass associated with fibrous dysplasia in a male patient with systemic lupus erythematosus (SLE). Int J Surg Case Rep 2021; 89:106564. [PMID: 34864256 PMCID: PMC8645914 DOI: 10.1016/j.ijscr.2021.106564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 11/28/2022] Open
Abstract
We present a rare clinical report of a 45-year-old man affected by Systemic Lupus Erythematosus (SLE) with a unilateral mass of the left frontal bone, diagnosed as a possible recurrence of fibrous dysplasia. This patient was evaluated with computed tomography (CT scan) and was treated with resection of the mass and reconstruction with splitting a calvarian bone graft. The pathological evidence was suggestive for a bone cavernous haemangioma. No previously described cases of bone dysplasia associated with this systemic syndrome were reported so far. Patient's disease was under stringent control at the time of hospitalization, and the outcome has been successful, even though a mild increase of inflammatory indexes was reported after surgery. This laboratory evidence was transient and not related to further clinical complications. Piezoelectric surgery allowed us to surgically treat a hemangioma. Hyperostosis found in the case report was due to hemangioma. Hyperostotic cases can be treated with piezosurgery. Case report with SLE
Collapse
Affiliation(s)
- Giorgio Giampaoli
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Unit of Maxillo-Facial Surgery, University of Verona, Verona, Italy
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Paola Di Ceglie
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Unit of Maxillo-Facial Surgery, University of Verona, Verona, Italy
| | - Dario Bertossi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Riccardo Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Unit of Otorhinolaryngology, University of Verona, Verona, Italy
| |
Collapse
|
13
|
Abstract
Vascular tumors of bone can be diagnostically challenging because of their rarity and histologic overlap with diverse mimics. Vascular tumors of bone can be categorized as benign (hemangioma), intermediate-locally aggressive (epithelioid hemangioma), intermediate-rarely metastasizing (pseudomyogenic hemangioendothelioma), and malignant (epithelioid hemangioendothelioma and angiosarcoma). Recurrent genetic alterations have been described, such as FOSB rearrangements in pseudomyogenic hemangioendothelioma and a subset of epithelioid hemangiomas; CAMTA1 or TFE3 rearrangements in epithelioid hemangioendothelioma. This review discusses the clinical, histologic, and molecular features of vascular tumors of bone, along with diagnostic pitfalls and strategies for avoidance.
Collapse
Affiliation(s)
- Yin P Hung
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
14
|
Ozturk R, Bulut EK. Intraosseous Hemangioma in the Humerus Diaphysis in an Eight-Year-Old Girl. Cureus 2021; 13:e17375. [PMID: 34584785 PMCID: PMC8456382 DOI: 10.7759/cureus.17375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 11/05/2022] Open
Abstract
In this study, we present an eight-year-old patient with intraosseous hemangioma in the right humerus diaphysis. The humerus diaphysis is an unusual localization for hemangioma. To our knowledge, this is the first case of intraosseous hemangioma in the humerus diaphysis in a pediatric patient. Treatment of intraosseous hemangiomas is controversial; options range from untreated follow-up to en-bloc resection. Intralesional curettage and grafting with cortico-cancellous allograft were performed in this case. Around 22 months postoperatively, she showed full shoulder and elbow function and there was no evidence of local recurrence or metastasis.
Collapse
Affiliation(s)
- Recep Ozturk
- Orthopedics and Traumatology, Dr Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital, Ankara, TUR
| | - Emin Kürşat Bulut
- Orthopedics and Traumatology, Dr Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital, Ankara, TUR
| |
Collapse
|
15
|
Ramkumar S. Epithelioid Haemangioma of Bone: A Case Series and Comprehensive Literature Review Reappraising the Diagnostic Classification of All Epithelioid Vascular Neoplasms of Bone. Cureus 2021; 13:e15371. [PMID: 34094789 PMCID: PMC8168629 DOI: 10.7759/cureus.15371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Epithelioid vascular neoplasms of the bone are classified by the World Health Organization (WHO) into only two tiers: low-grade epithelioid hemangioma (EH) and a more malignant category including both epithelioid hemangioendothelioma and epithelioid angiosarcoma. The World Health Organization defines bone EH as a locally aggressive neoplasm with no connotation of benign or intermediate malignancy. We reviewed three cases of EH in our lab archives with the perspective of appraising their histomorphological approach toward diagnosis. Patients were in the age range of 15-25 years. The site of the neoplasms ranged from the carpal bones to the metatarsal bones. Histomorphological examination of the lesions showed a nodular growth pattern of a vascular neoplasm without demonstrable vessel origin. The vasoformative area increased from the center to the periphery, with prominent epithelioid morphology of the endothelial cells at the periphery and an associated inflammatory infiltrate comprising eosinophils, lymphocytes, and plasma cells. The growth pattern was diffuse, with extension into the deeper dermis of overlying skin.
Collapse
|
16
|
Zhou Q, Lu L, Yang Z, Su S, Hong G. Hemangioma of long tubular bone: imaging characteristics with emphasis on magnetic resonance imaging. Skeletal Radiol 2020; 49:2029-2038. [PMID: 32594199 DOI: 10.1007/s00256-020-03527-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the imaging findings, especially the MRI findings, of intraosseous hemangioma of long tubular bones and to improve the recognition of this rare tumor. MATERIALS AND METHODS The imaging characteristics of 16 histopathologically diagnosed long tubular bone hemangioma lesions were retrospectively reviewed on radiography (n = 16), CT (n = 16), and MRI (n = 15). RESULTS Thirteen of 16 lesions were intramedullary, whereas the other three were cortical, subperiosteal, and mixed intracortical and intramedullary, respectively. The radiologic appearance of long bone intraosseous hemangioma was divided into five types: cyst-like (n = 7), mesh- or honeycomb-like (n = 6), medullary sclerosis (n = 1), cortical thickening (n = 1), and cortical lytic type (n = 1). Radiography and CT allowed the identification of sclerotic margins in eight cases, thickened trabeculae in six cases, internal calcification in one case, cortical thickening in one case, and fracture in four cases. Two lesions were confusing on radiography but clearly identifiable on MRI. All intraosseous hemangioma showed high signal intensity on T2-weighted imaging and intermediate signal intensity on T1-weighted imaging. Four cyst-like lesions showed peripheral and filling enhancement, whereas others exhibited diffuse enhancement with an intensity similar to adjacent vessels. CONCLUSION Cystic and mesh types are the most common types of hemangioma in long tubular bones. MRI can help to define the location and extent of lesions. The tumor usually shows high signal intensity on T2-weighted imaging and intermediate signal intensity on T1-weighted imaging. Peripheral and filling or diffuse enhancement with an intensity similar to vessels is helpful for the diagnosis of intraosseous hemangioma.
Collapse
Affiliation(s)
- Qin Zhou
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Liangji Lu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, 310009, China
| | - Zhiyun Yang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Shu Su
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Guixun Hong
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
| |
Collapse
|
17
|
Primary Vascular Tumors of Bone: A Monoinstitutional Morphologic and Molecular Analysis of 427 Cases With Emphasis on Epithelioid Variants. Am J Surg Pathol 2020; 44:1192-1203. [PMID: 32271190 DOI: 10.1097/pas.0000000000001487] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Recent molecular discoveries have refined vascular bone tumor classification. To investigate the clinical relevance of these refinements, we reviewed all cases of primary vascular bone tumors treated at our Institute. On the basis of morphology, cases were assessed immunohistochemically and molecularly. A total of 427 cases of primary vascular tumor of bone with available follow-up and histologic material were retrieved and reclassified according to the most recent diagnostic criteria as follows: 289 hemangiomas, 38 epithelioid hemangiomas, 21 epithelioid hemangioendotheliomas, 2 retiform hemangioendotheliomas, 1 intraosseous papillary intralymphatic angioendothelioma, 24 pseudomyogenic hemangioendotheliomas, and 52 angiosarcomas (of these, 45 were epithelioid angiosarcomas and 7 spindle cell secondary angiosarcoma). Both epithelioid and classic hemangiomas behave as benign tumors with excellent prognosis. The distinction between cellular and conventional type of epithelioid hemangioma was not associated with a different clinical course. Conversely, epithelioid hemangioendothelioma exhibited a more aggressive clinical behavior than hemangioma, with higher rates of multifocality and distant spread. Immunohistochemical positivity for CAMTA1 or TFE3 did not have a prognostic implication. In epithelioid hemangioendothelioma, the presence of morphologic malignant features was associated with reduced disease-free (P=0.064) and overall survival (P=0.055). Pseudomyogenic hemangioendothelioma featured local aggressiveness in 5/24 patients exhibiting a clinical behavior closer to epithelioid hemangioma than epithelioid hemangioendothelioma. Last, 32/45 patients with epithelioid angiosarcoma died of disease with a median survival time of 10 months from diagnosis. In conclusion, the integration of morphologic, immunohistochemical, and molecular features allows a better stratification of primary vascular tumors of bone with significant prognostic and therapeutic implications.
Collapse
|
18
|
Hoyle JM, Layfield LJ, Crim J. The lipid-poor hemangioma: an investigation into the behavior of the "atypical" hemangioma. Skeletal Radiol 2020; 49:93-100. [PMID: 31250038 DOI: 10.1007/s00256-019-03257-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/04/2019] [Accepted: 06/06/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Most vertebral hemangiomas contain high signal intensity on T1-weighted MRI images. Atypical vertebral hemangiomas, which are defined as showing low-signal intensity on T1-weighted images, have been described as lesions which are prone to aggressive behavior. This study was performed to assess behavior of atypical hemangiomas. MATERIALS AND METHODS Thoracic and lumbar spine MRI reports for the year 2012 were reviewed for diagnosis of atypical hemangioma. Images were reviewed by two independent observers, and cases which showed atypical vertebral hemangioma, and had imaging or clinical follow-up, were included in our study. RESULTS Thirty atypical hemangiomas which had follow-up data were identified out of 2784 thoracic and lumbar MR examinations performed during 2012 at a single institution. Imaging follow-up was available for 23 lesions (mean follow-up 32 months), while there was clinical follow-up for the remaining seven lesions (mean 43.6 months). Twenty-two lesions were stable on imaging, while one demonstrated significant growth over approximately 6 years, developing MRI signal characteristics of a typical hemangioma. Eleven lesions had CT scans showing typical features of hemangioma. Two of the index lesions could not be identified on follow-up CT examinations, which showed normal-appearing spines. The remaining seven lesions were followed clinically; none of the patients reported symptoms in the region of the index lesions. CONCLUSIONS Atypical hemangiomas are uncommon lesions. The cases in our population did not show aggressive behavior. A more appropriate designation for these lesions may be lipid-poor hemangioma, to distinguish them from aggressive hemangiomas.
Collapse
Affiliation(s)
- J M Hoyle
- University of Missouri at Columbia, 1 Hospital Dr., Columbia, MO, 65212, USA
| | - L J Layfield
- University of Missouri at Columbia, 1 Hospital Dr., Columbia, MO, 65212, USA
| | - J Crim
- University of Missouri at Columbia, 1 Hospital Dr., Columbia, MO, 65212, USA.
| |
Collapse
|
19
|
Fairfax A, Dey CB, Shaves S. Multifocal epithelioid hemangioma of the metacarpal bones: A case report. Radiol Case Rep 2019; 14:1467-1472. [PMID: 31641394 PMCID: PMC6796626 DOI: 10.1016/j.radcr.2019.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/14/2019] [Accepted: 09/15/2019] [Indexed: 11/17/2022] Open
Abstract
Epithelioid hemangioma of bone is a rare, locally aggressive but benign vascular tumor that is now recognized as a distinct entity from other vascular neoplasms. It is often difficult to distinguish on imaging studies from other vascular tumors, including epithelioid hemangioendothelioma, which can lead to misdiagnosis and inappropriate treatment. We present the characteristic features and multimodality imaging findings in the case of a 24-year-old female with multifocal epithelioid hemangioma of the first and second metacarpal bones with extension into the surrounding soft tissue.
Collapse
Affiliation(s)
| | - Courtney B. Dey
- Department of Radiology, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23501
| | - Sarah Shaves
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA
| |
Collapse
|
20
|
Paladino LP, Belzarena AC, Henderson-Jackson E, Joyce DM. Metastatic vertebral lesion mimicking an atypical hemangioma with negative 18F-FDG positron emission tomography-computed tomography. Radiol Case Rep 2019; 14:1401-1406. [PMID: 31700555 PMCID: PMC6823801 DOI: 10.1016/j.radcr.2019.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 01/10/2023] Open
Abstract
Atypical hemangiomas of the spine can mimic metastatic lesions on magnetic resonance imaging, therefore making this distinction is a diagnostic challenge. In most cases, this conundrum can usually be solved with positron emission tomography/computed tomography images, because hemangiomas do not usually present with increased uptake while metastatic lesions do. Here we present a case of a patient with a unique diagnosis, myxoid liposarcoma, in which the vertebral metastatic lesion did not present with increased uptake in positron emission tomography/computed tomography scans. While keeping the imaging particularity of this rare sarcoma in mind, proceeding with a biopsy when the suspicion of metastasis remains high will help elucidate the diagnosis and allow for proper management.
Collapse
Affiliation(s)
- Lucas Paul Paladino
- Sarcoma Department, Moffitt Cancer Center, 12902 Magnolia Dr.,Tampa, FL, 33612, USA
| | - Ana C. Belzarena
- Orthopaedic Oncology Department, Miami Cancer Institute, 8900 N Kendall Dr., Miami, FL, 33176, USA
| | | | - David M. Joyce
- Sarcoma Department, Moffitt Cancer Center, 12902 Magnolia Dr.,Tampa, FL, 33612, USA
| |
Collapse
|
21
|
Broida S, Reimer N, Read WL. Recurrent Epithelioid Hemangioma of the Bony Pelvis Responding to Propranolol. Case Rep Oncol 2019; 12:704-708. [PMID: 31607887 PMCID: PMC6787426 DOI: 10.1159/000502947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/04/2019] [Indexed: 12/16/2022] Open
Abstract
Epithelioid hemangioma is an uncommon benign vascular neoplasm which can arise in bone. Resection is generally curative, but occasionally lesions recur and recurrence after surgery can be morbid and destructive. Recent case reports have described the effective use of oral propranolol to control recurrent epithelioid hemangioma of the orbit. We report the case of a 26 year old man with recurrent aggressive osseous epithelioid hemangioma in the pelvis of which has been controlled for over a year with outpatient propranolol monotherapy.
Collapse
|
22
|
Pechenkina K, Fan W, Luo X. What's that big thing on your head? Diagnosis of a large frontoparietal lesion on an Eastern Zhou skull from Henan, China. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 26:84-92. [PMID: 31349131 DOI: 10.1016/j.ijpp.2019.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 06/18/2019] [Accepted: 06/23/2019] [Indexed: 06/10/2023]
Abstract
We carried out a differential diagnosis of a large frontoparietal lesion on a human skull from a Late Bronze Age archaeological site located on the Central Plain of China, dating to between 771 and 476 BC. The head of this individual was covered in cinnabar, a mercury-based pigment that later was used for medicinal purposes in China. The lesion was well-circumscribed and involved the outer and inner tables of the skull, slight diploë thickening, and coarsening of bone trabeculae with expansion of intertrabecular spaces. We show that the observed changes are most consistent with cavernous hemangioma of the skull, a benign vascular malformation that preferentially affects older adults. Hemangiomas are often neglected in the paleopathological literature because of their benign nature - they tend to be asymptomatic and do not affect quality of life to a significant degree. Nevertheless, they produce characteristic lesions that can be confused with several other conditions with unrelated etiologies, including congenital hemoglabinopathies, traumas, malignant or benign neoplasms, and Paget's disease. We outline the diagnostic criteria that distinguish cavernous hemangioma from other conditions affecting the skull.
Collapse
Affiliation(s)
| | - Wenquan Fan
- Henan Provincial Institute of Cultural Relics and Archaeology, China
| | | |
Collapse
|
23
|
Dianat S, Yousaf H, Murugan P, Marette S. Pseudomyogenic hemangioendothelioma-A case report and review of the literature. Radiol Case Rep 2019; 14:1228-1232. [PMID: 31440320 PMCID: PMC6699196 DOI: 10.1016/j.radcr.2019.06.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/29/2019] [Indexed: 12/19/2022] Open
Abstract
Pseudomyogenic hemangioendothelioma (PMH) of bone is a very rare tumor and frequently presents at multiple locations. PMH is difficult to diagnose by imaging and histopathologic features. Various and partially discordant imaging findings have been reported in case reports and small case series. We report a case of a 63-year-old man with PMH isolated to the sacrum, presenting with chronic intermittent buttock pain that was incidentally identified on imaging for acute pancreatitis. We believe that learning about PMH of bone will help to include this disease in the differential diagnosis of lytic lesions of the sacrum. Becoming aware of the various and sometimes discordant imaging findings of this rare entity is important and helpful for radiologists, pathologists, and orthopedic surgeons.
Collapse
Affiliation(s)
- Saeed Dianat
- Department of Radiology, University of Minnesota, 20 Delaware St SE, Minneapolis, MN 55455, USA
| | - Hira Yousaf
- Department of Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Paari Murugan
- Department of Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Shelly Marette
- Department of Radiology, University of Minnesota, 20 Delaware St SE, Minneapolis, MN 55455, USA
| |
Collapse
|
24
|
Freiburg Neuropathology Case Conference : A Painless Mass Lesion of the Parietal and Occipital Bones. Clin Neuroradiol 2018; 28:301-306. [PMID: 29696306 DOI: 10.1007/s00062-018-0691-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
25
|
van IJzendoorn DGP, Bovée JVMG. Vascular Tumors of Bone: The Evolvement of a Classification Based on Molecular Developments. Surg Pathol Clin 2018; 10:621-635. [PMID: 28797505 DOI: 10.1016/j.path.2017.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The classification of vascular tumors of bone has been under debate over time. Vascular tumors in bone are rare, display highly overlapping morphology, and, therefore, are considered difficult by pathologists. Compared with their soft tissue counterparts, they are more often multifocal and sometimes behave more aggressively. Over the past decade, with the advent of next-generation sequencing, recurrent molecular alterations have been found in some of the entities. The integration of morphology and molecular changes has led to a better characterization of these separate entities.
Collapse
Affiliation(s)
- David G P van IJzendoorn
- Department of Pathology, Leiden University Medical Center, Postzone L1-Q, Postbus 9600, Leiden 2300 RC, The Netherlands
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Postzone L1-Q, Postbus 9600, Leiden 2300 RC, The Netherlands.
| |
Collapse
|
26
|
Epithelioid hemangioma of the scapula treated with chemoembolization and microwave ablation: Α case report. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2018; 52:157-161. [PMID: 28159479 PMCID: PMC6136344 DOI: 10.1016/j.aott.2017.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/09/2016] [Accepted: 01/02/2017] [Indexed: 01/20/2023]
Abstract
Bone epithelioid hemangiomas are classified within benign vascular tumours but are commonly misdiagnosed as low-grade angiosarcomas or epithelioid hemangioendotheliomas. Current therapeutic interventions include various treatment options but local recurrence or distal lymph node involvement has been reported. We report a rare case of scapular epithelioid hemangioma that was initially treated using a combination of chemoembolization and microwave ablation. This combination has not been previously reported in the literature regarding the management of this tumour. A year after the first course of treatment, the tumour size has been reduced more than 70% and the patient has remarkable clinical improvement. Results reported in this case study demonstrated that combination of chemoembolization and microwave ablation is a feasible, safe and effective technique in the treatment of bone epithelioid hemangiomas. Even if the tumour is still present afterwards, a substantially smaller surgical excision will be needed.
Collapse
|
27
|
Andreacchio A, Alberghina F, Giacometti V, Marengo L, Canavese F. Single-Stage Surgery Using Calcium Sulfate Pellets in Association with Tumor Resection as Treatment for Intraosseous Hemangioma of the Radius Shaft in a 2-Year-Old Boy. J Hand Microsurg 2018; 9:154-158. [PMID: 29302139 DOI: 10.1055/s-0037-1605355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022] Open
Abstract
Intraosseous hemangiomas are uncommon benign vascular tumors. Here the authors report a case of intraosseous hemangioma of the radial shaft in a 2-year-old boy, surgically treated by tumor mass resection and application of calcium sulfate pellets with no signs of relapse over a 2-year follow-up. Moreover, the lesion healed with new bone formation, and the last plain radiographs suggested homogenous normal trabecular bone density. The radius grew in length and remodeled to an almost normal shape. Clinically, elbow flexion-extension and forearm pronation and supination were within normal limits at the last follow-up visit. This report points to calcium sulfate pellets as a valid alternative to autologous bone grafting as void filler in large bone defects. Calcium sulfate pellets enable fast osteoinduction without interfering in follow-up imaging.
Collapse
Affiliation(s)
- Antonio Andreacchio
- Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
| | - Flavia Alberghina
- Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
| | - Vanessa Giacometti
- Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
| | - Lorenza Marengo
- Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
| | - Federico Canavese
- Department of Pediatric Surgery, University Hospital Estaing, Clermont Ferrand, France
| |
Collapse
|
28
|
Epithelioid hemangioma of bone: radiologic and magnetic resonance imaging characteristics with histopathological correlation. Pediatr Radiol 2017; 47:1631-1637. [PMID: 28721475 DOI: 10.1007/s00247-017-3922-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/10/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Epithelioid hemangioma is a rare vascular tumor that can occur in soft tissues or bone. The tumor is part of a spectrum of vascular tumors that also includes epithelioid hemangioendothelioma and angiosarcoma. When involving the bone, the tumor usually involves the metaphysis or diaphysis of the long tubular bones and most commonly occurs in adults. It has been rarely reported in pediatric patients, and in these reported patients, the tumor primarily involves the epiphysis. OBJECTIVE To review three cases of epithelioid hemangioma of bone occurring in pediatric patients involving the epiphysis and to explore the imaging features of this tumor. MATERIALS AND METHODS Retrospectively review three cases of epithelioid hemangioma occurring in skeletally immature patients. RESULTS These tumors primarily involved the epiphyses or epiphyseal equivalent bones. One lesion was centered in the metaphysis but extended to the epiphysis. These are three cases presenting in an unusual location and at an unusual age. CONCLUSION Epithelioid hemangioma, though rare, can occur in pediatric patients and appears to involve the epiphyses in these patients. This is in contrast to the usual age and location reported. Epithelioid hemangioma may be considered for an epiphyseal lesion in a skeletally immature patient.
Collapse
|
29
|
Diagnostic Imaging of Primary Bone Tumors of the Spine. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0220-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
30
|
Ofluoglu AE, Aydogan M, Erdogan U, Ofluoglu O. Epithelioid hemangioendothelioma of the craniocervical junction; case report and review. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:342-346. [PMID: 28478911 PMCID: PMC6197577 DOI: 10.1016/j.aott.2017.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/27/2015] [Accepted: 12/24/2015] [Indexed: 11/26/2022]
Abstract
Epithelioid hemangioendotheliomas are uncommon vascular neoplasms and their spinal location is even rarer. We report clinical course of a 31-year-old man with an epithelioid hemangioendothelioma at the cranio-cervical junction. A cervical magnetic resonance imaging revealed tumor that caused posterior cervical cord compression. C1,2,3 total laminectomy and surgical excision of the tumor was performed. Postoperative external beam radiation was performed on the surgical field especially around the right vertebral artery. At 2-year follow-up there was no neurological deficit and no tumor recurrence.
Collapse
|
31
|
DeSandis B, Karnovsky SC, Perino G, Drakos MC. The Disappearing Phalanx: A Case Report of a Vascular Tumor of the Toe. J Foot Ankle Surg 2017. [PMID: 28633787 DOI: 10.1053/j.jfas.2017.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report a unique case of an epithelioid hemangioma of the third middle phalanx in which the lesion replaced the phalanx, became symptomatic, and then required resection, bone grafting, and joint arthroplasty. To the best of our knowledge, this is the first report of an epithelioid hemangioma in the toe that was treated using this approach.
Collapse
Affiliation(s)
| | | | - Giorgio Perino
- Associate Attending Pathologist, Department of Pathology, Hospital for Special Surgery, New York, NY
| | - Mark C Drakos
- Associate Attending Orthopedic Surgeon, Department of Orthopedic Surgery, Foot and Ankle Service, Hospital for Special Surgery, New York, NY
| |
Collapse
|
32
|
Abstract
Hemangiomas are benign tumors, which are mainly composed of neoplastic blood vessels. The exact pathogenesis is still unclear. They are the most common benign spinal tumors and also occur less commonly in the bones of the extremities. Hemangiomas are often clinically asymptomatic and are diagnosed as incidental findings. Women are affected more frequently than men (2:1). The X‑ray and computed tomography (CT) diagnostics typically demonstrate the classical honeycombing or vertically orientated lucencies separated by thickened cancellous bone in the affected skeletal section. Vertebral hemangiomas are hyperintense in both T1 and T2-weighted magnetic resonance imaging (MRI). The treatment of vertebral hemangiomas ranges from irradiation, embolization and vertebroplasty to operative decompression, resection of the tumor and instrumented stabilization. In the long bones intralesional curettage and bone grafting with additive osteosynthesis is the main treatment modality. The prognosis for osseous hemangiomas is good.
Collapse
Affiliation(s)
- M Rickert
- Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstr. 2, 60528, Frankfurt am Main, Deutschland.
| | - A Meurer
- Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstr. 2, 60528, Frankfurt am Main, Deutschland
| |
Collapse
|
33
|
Differential CT and MR imaging diagnosis between low- and high-grade malignant vascular tumors of bone. SPRINGERPLUS 2016; 5:1772. [PMID: 27795914 PMCID: PMC5061671 DOI: 10.1186/s40064-016-3471-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 10/05/2016] [Indexed: 01/24/2023]
Abstract
Objective To investigate the CT and MR imaging findings and differential diagnosis of malignant vascular tumors of bone.
Materials and methods CT and MR imaging findings of 18 patients with histopathology-proven malignant vascular tumors of bone were examined. Assessed image features included age, sex, location, CT findings, and MR imaging appearances and dynamic contrast-enhanced MR imaging.
Results The study group comprised 18 cases, of which 7 were categorized as low-grade malignant vascular tumors (LMT), and 11 were categorized as high-grade malignant vascular tumors (HMT). Malignant vascular tumors of bone showed osteolytic lesions with heterogeneous signs and enhancement, and frequently associated with soft tissue masses and peritumorous edema. The mean age of patient was respectively 34.7 years in LMT with 3 patients younger than 20 and 49.9 years in HMT with 3 patients older than 60 years. The mean lesion diameter was 3.6 cm (range 2–7.2) in LMT with two lesions <3 cm and 7.1 cm (range 3–13) in HMT with 3 lesions greater than 10 cm. LMT showed multifocal (57.1 %) and well-defined (71.5 %) lesions with residual bone (57.1 %), peripheral sclerosis (85.7 %), and slightly hetergeneous enhancement (71.4 %), compared to those of HMT with 9.1, 45.5, 27.3, and 72.7 %, and 9.1 % respectively. Also, HMT appeared as expansive (54.5 %), ill-defined (54.5 %), macroscopic necrosis/cystic (81.8 %) or hemorrhagic (27.3 %) lesion with pathological fracture (27.3 %), and often presented with obviously hetergeneous enhancement (81.8 %), compared to those of LMT with 42.9, 28.6, 42.9, 0, 14.3 and 14.3 % respectively. Conclusions There are some differences in the imaging features between LMT and HMT, while unifocal/multifocal, expansive, ill-defined, necrosis/cystic, hemorrhagic features with age, lesion diameter, peripheral sclerosis, residual bone tissue, pathological fracture and slightly/obviously hetergeneous enhancement highly suggest their differential diagnosis.
Collapse
|
34
|
Cetinkaya A, Xiong J, Vargel İ, Kösemehmetoğlu K, Canter H, Gerdan Ö, Longo N, Alzahrani A, Camps M, Taskiran E, Laupheimer S, Botto L, Paramalingam E, Gormez Z, Uz E, Yuksel B, Ruacan Ş, Sağıroğlu M, Takahashi T, Reversade B, Akarsu N. Loss-of-Function Mutations in ELMO2 Cause Intraosseous Vascular Malformation by Impeding RAC1 Signaling. Am J Hum Genet 2016; 99:299-317. [PMID: 27476657 DOI: 10.1016/j.ajhg.2016.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 06/09/2016] [Indexed: 12/16/2022] Open
Abstract
Vascular malformations are non-neoplastic expansions of blood vessels that arise due to errors during angiogenesis. They are a heterogeneous group of sporadic or inherited vascular disorders characterized by localized lesions of arteriovenous, capillary, or lymphatic origin. Vascular malformations that occur inside bone tissue are rare. Herein, we report loss-of-function mutations in ELMO2 (which translates extracellular signals into cellular movements) that are causative for autosomal-recessive intraosseous vascular malformation (VMOS) in five different families. Individuals with VMOS suffer from life-threatening progressive expansion of the jaw, craniofacial, and other intramembranous bones caused by malformed blood vessels that lack a mature vascular smooth muscle layer. Analysis of primary fibroblasts from an affected individual showed that absence of ELMO2 correlated with a significant downregulation of binding partner DOCK1, resulting in deficient RAC1-dependent cell migration. Unexpectedly, elmo2-knockout zebrafish appeared phenotypically normal, suggesting that there might be human-specific ELMO2 requirements in bone vasculature homeostasis or genetic compensation by related genes. Comparative phylogenetic analysis indicated that elmo2 originated upon the appearance of intramembranous bones and the jaw in ancestral vertebrates, implying that elmo2 might have been involved in the evolution of these novel traits. The present findings highlight the necessity of ELMO2 for maintaining vascular integrity, specifically in intramembranous bones.
Collapse
|
35
|
|
36
|
Floris G, Deraedt K, Samson I, Brys P, Sciot R. Epithelioid Hemangioma of Bone: A Potentially Metastasizing Tumor? Int J Surg Pathol 2016; 14:9-15; discussion 16-20. [PMID: 16501828 DOI: 10.1177/106689690601400102] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The case of a 15-year-old boy with a severe swelling of the 2nd toe in the left foot and a large swelling of the left inguinofemoral region is described. Histologic examination of the foot lesion showed a typical epithelioid hemangioma of bone that extended into the soft tissues, with a secondary location in the groin, suggestive of lymph node involvement. Subsequently, imaging also revealed swelling of iliac and para-aortic lymph nodes, which probably indicates further lymph node spread.. Besides the fact that epithelioid hemangioma of the toe has not been reported yet, our case showed a noncontinuous localization, most likely in draining lymph nodes. This finding suggests metastatic disease, an event that is extremely rare for epithelioid hemangioma. As such, epithelioid hemangioma might be comparable to another benign vascular tumor, the retiform hemangioendothelioma, which occasionally metastasizes to the lymph nodes without systemic spread.
Collapse
Affiliation(s)
- Giuseppe Floris
- Department of Pathology, University Hospitals, Catholic University of Leuven, Leuven, Belgium
| | | | | | | | | |
Collapse
|
37
|
Rajebi H, Madanipour S, Shiraj S, Yegorov A. The debate is still open; benign or malignant: a case report of a multifocal epithelioid haemangioma of fibula. BJR Case Rep 2016; 2:20150269. [PMID: 30363650 PMCID: PMC6180897 DOI: 10.1259/bjrcr.20150269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 01/10/2016] [Accepted: 01/18/2016] [Indexed: 11/17/2022] Open
Abstract
In this case, we report an epithelioid haemangioma (EH) of the fibula with ill-defined multifocal lesions and a resultant pathologic fracture. Based on radiographic appearance, these lesions were initially thought to represent a malignant process, such as primary malignant bone tumour, metastases or multiple myeloma. Osseous EHs are rare. Although they can present as multifocal lesions, the majority of bony EHs are solitary and arise in the diaphysis or metaphysis of long tubular bones, with a predilection for the lower extremity. Non-specific radiological findings, debatable cytological appearance and unpredictable clinical growth patterns commonly cause misdiagnosis of malignancy. To the best of our knowledge, a case of EH with multiple growing lesions of the fibula has not yet been reported in the literature.
Collapse
Affiliation(s)
- Hamid Rajebi
- Radiology Department, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Shahzad Madanipour
- Radiology Department, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Sahar Shiraj
- Radiology Department, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Arthur Yegorov
- Radiology Department, SUNY Upstate Medical University, Syracuse, NY, USA
| |
Collapse
|
38
|
Jeon JY, Chung HW, Kwon JW, Hong SH, Lee GY, Ryu KN. Imaging findings of various talus bone tumors-clinico-radiologic features of talus bone tumors. Clin Imaging 2016; 40:666-77. [PMID: 27317211 DOI: 10.1016/j.clinimag.2016.02.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 12/12/2022]
Abstract
Osseous neoplasms of the foot are uncommon, accounting for only 3.3% of all primary bone tumors. Bone tumors of the talus are even rarer, and there are not many publications that comprehensively evaluate the imaging findings of talus tumors. The purpose of this article is to review the benign and malignant bone tumors affecting this uncommon site and to describe the clinical and radiologic features of each tumor.
Collapse
Affiliation(s)
- Ji Young Jeon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center
| | - Hye Won Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center.
| | - Jong Won Kwon
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Korea.
| | - Sung Hwan Hong
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
| | - Guen Young Lee
- Departments of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundanggu, Seongnam-si, Gyeonggi-do, 436-707, Korea.
| | - Kyung Nam Ryu
- Department of Radiology, Kyung Hee University Medical Center, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-702, Korea.
| |
Collapse
|
39
|
Kelahan LC, Sandhu FA, Sayah A. Multifocal hemangioendothelioma of the lumbar spine and response to surgical resection and radiation. Spine J 2015; 15:e49-56. [PMID: 26165479 DOI: 10.1016/j.spinee.2015.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/03/2015] [Accepted: 07/01/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Epithelioid hemangioendothelioma rarely occurs in the lumbosacral spine, with very few case reports of spinal hemangioendothelioma in the literature. There is variability in aggressiveness of these lesions without established treatment guidelines. PURPOSE The aim was to present a case of epithelioid hemangioendothelioma in the lumbar spine, including magnetic resonance imaging (MRI) findings, which rapidly progressed over a 2-month period as regional multifocal lumbosacral spinal lesions with epidural extension causing severe spinal canal stenosis. STUDY DESIGN/SETTING This was a case report in a university hospital setting. PATIENT SAMPLE The sample included an otherwise healthy adult male with low back pain. METHODS Multimodality imaging was performed to help with diagnosis and management including computed tomography, MRI, and positron emission tomography (PET). The patient was treated by embolization, L5 corpectomy and L4-S1 stabilization, and radiation therapy. The diagnosis was confirmed by tissue biopsy. RESULTS The patient initially presented with severe back and leg pain after a vertebroplasty for an L5 compression fracture at an outside hospital where biopsy was negative for malignancy. Magnetic resonance imaging showed diffuse abnormality of L5 with several smaller lesions in the sacrum. Due to progressive pain 2 weeks after the vertebroplasty, the patient underwent an L5 laminectomy, L4-S1 instrumented posterior fusion, and attempted partial corpectomy for stenosis. At this surgery, the L5 corpectomy was aborted owing to profound bleeding. Pathology was again negative for malignancy. Presumed to be an atypical hemangioma, the lesion was embolized before repeat surgery where the thecal sac was decompressed by partial L5 corpectomy. Biopsy at this time revealed a vascular neoplasm, with hemangioendothelioma not excluded. Approximately 2 months after the stabilization procedure, the patient had increasing pain and bilateral lower extremity weakness. Magnetic resonance imaging was performed and demonstrated marked local progression of disease with new multifocal lesions involving L4 through S2 vertebrae and new severe spinal canal stenosis. These lesions were subsequently treated with localized radiation therapy. Magnetic resonance imaging 2 months after radiation therapy showed significant regression of the epidural tumor although a new metastatic lesion was discovered at T6 vertebra. CONCLUSIONS Spinal hemangioendothelioma is a rare disease and can present in variable forms, including as a multifocal regional process--which may be mistaken for infection. Additionally, there are no standard treatment protocols for this entity. We present the extensive imaging and treatment of a single case of rapidly progressive lumbar epithelioid hemangioendothelioma, which to our knowledge has not been described with this multifocal appearance in the lumbar spine.
Collapse
Affiliation(s)
- Linda C Kelahan
- Department of Radiology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, CG201, Washington, DC 20007, USA.
| | - Faheem A Sandhu
- Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, 7PHC, Washington, DC 20007, USA
| | - Anousheh Sayah
- Department of Radiology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, CG201, Washington, DC 20007, USA
| |
Collapse
|
40
|
The Radiologic Diagnosis and Treatment of Typical and Atypical Bone Hemangiomas: Current Status. Can Assoc Radiol J 2015; 67:2-11. [PMID: 26514943 DOI: 10.1016/j.carj.2014.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 07/15/2014] [Accepted: 07/23/2014] [Indexed: 12/26/2022] Open
|
41
|
Bregman JA, Jordanov MI. Epithelioid hemangioma occurring in the radial styloid of a 17-year-old boy—an unusual presentation of an uncommon neoplasm. Clin Imaging 2014; 38:899-902. [DOI: 10.1016/j.clinimag.2014.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/17/2014] [Accepted: 06/19/2014] [Indexed: 10/25/2022]
|
42
|
Importance of MRI in the diagnosis of vertebral involvement in generalized cystic lymphangiomatosis. Skeletal Radiol 2014; 43:1633-8. [PMID: 24950879 DOI: 10.1007/s00256-014-1935-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 04/30/2014] [Accepted: 06/01/2014] [Indexed: 02/02/2023]
Abstract
A 9-year-old boy presented with the sudden onset of pleuritic chest pain and on CT was found to have a large pleural effusion, mediastinal fluid, splenic lesions and multiple apparently sclerotic vertebral bodies. Subsequent MRI showed that those vertebral bodies that appeared sclerotic were in fact normal, and the vertebral bodies initially interpreted as normal had an abnormal T1 and T2 hyperintense signal on MRI and were relatively lucent on CT. MRI also demonstrated abnormal heterogeneous T2 hyperintense paraspinal tissue and several multicystic soft tissue masses. Biopsy of two adjacent vertebral bodies, one relatively sclerotic and one lucent, demonstrated findings of bony remodeling without a specific diagnosis. Biopsy of an infiltrative mediastinal mass confirmed the diagnosis of generalized cystic lymphangiomatosis. MRI should be included in the assessment of vertebral involvement in this condition because CT and biopsy findings may be nonspecific.
Collapse
|
43
|
Silva FD, Pinheiro L, Cristofano C, de Oliveira Schiavon JL, Lederman HM. Magnetic Resonance Imaging in Pediatric Bone Tumors. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0077-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
44
|
Epithelioid hemangioendothelioma of the spine: results at seven years of average follow-up in a series of 10 cases surgically treated and a review of literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24:2156-64. [PMID: 25118684 DOI: 10.1007/s00586-014-3510-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 08/03/2014] [Accepted: 08/03/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To review a series of ten cases with epithelioid hemangioendothelioma of the spine, that have undergone surgery to describe clinical presentation, results and complications associated with surgical treatment; a review of literature reporting the main characteristics of the cases already published has been reported. METHODS A review of patients affected by epithelioid hemangioendothelioma surgically treated by the senior author from 1995 to 2012 was carried out. Ten cases were identified and clinical and radiological characteristics, therapy, complications and survival were valued. RESULTS Wide margin was achieved in two out of ten cases, marginal margin in seven and intralesional margin in one case. Average intraoperative blood loss was about 2,800 ml. Reported complications were one case of cord injury, one of dural tear, two cases of massive blood loss, a case of reconstruction failure, a wound dehiscence with deep infection, a pneumonia episode and a deep vein thrombosis with pulmonary embolism. Average follow-up was 84.4 months. Two local recurrences, after 32 and 37 months and two deaths for metastasis, after 14 and 36 months, were reported. Although several chemotherapy protocols are available for the treatment of EH of soft tissue, they are not relevant for the bone. CONCLUSIONS Wide surgery is probably associated with a better prognosis. Indeed most deaths and local recurrences reported in literature happened after intralesional surgery or chemotherapy/RT alone. The presenting study suggests that the best approach to achieve long-term local control and a major survival could be wide surgery, nevertheless more cases series are necessary to verify survival rate.
Collapse
|
45
|
Kim JE, Yi WJ, Heo MS, Lee SS, Choi SC, Huh KH. An unusual case of intraosseous vascular malformation of the maxilla mimicking fibrous dysplasia: a case report and literature review on imaging features of intraosseous vascular anomalies of the jaw. Dentomaxillofac Radiol 2014; 43:20130400. [PMID: 24940806 DOI: 10.1259/dmfr.20130400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Intraosseous vascular malformation (IVM) is a relatively rare pathological condition that may pose significant risks, such as excessive bleeding, during surgical procedures. We present a case of an 18-year-old female patient with firm swelling in the left maxilla. A bony expansion over the left half of the maxilla with preservation of the outer cortex and a ground glass appearance on CT images initially revealed a possibility of fibrous dysplasia. However, a tentative diagnosis of IVM was made based on the vascular nature of the lesion as well as the patient's surgical history and additional imaging findings. IVM should be included in the differential diagnosis of an expansile bony lesion with trabecular alteration. Through the literature review, it was found that imaging findings, such as a neurovascular canal widening on CT images and a hyperintense signal on T1 weighted MR images, might be helpful in differentiating IVM from other pathologies.
Collapse
Affiliation(s)
- J-E Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | | | | | | | | | | |
Collapse
|
46
|
Bisbinas I, Karabouta Z, Georgiannos D, Lampridis V, Badekas A. Multifocal epithelioid hemangioendothelioma of the foot and ankle: a case report. J Orthop Surg (Hong Kong) 2014; 22:122-5. [PMID: 24781630 DOI: 10.1177/230949901402200130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report on a 41-year-old man with multiple epithelioid hemangioendothelioma of the left foot and ankle. The patient was treated with curettage and fixation with 2 separate plates, but later developed local infection. Owing to the potential for malignancy, below-knee amputation was suggested, but the patient declined and was treated symptomatically with close monitoring. The patient underwent removal of the plates, excision of the distal fourth of the fibula, intralesional curettage of all lesions, and fusion of the ankle and subtalar joints with a retrograde intramedullary nail. After 5.5 years, the patient had recovered well and had no evidence of malignancy. The tumour was considered definitively benign.
Collapse
Affiliation(s)
- Ilias Bisbinas
- A' Department in Orthopaedics and Trauma Surgery, 424 Military General Hospital, Thessaloniki, Greece
| | - Zacharoula Karabouta
- Department of Paediatrics, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Georgiannos
- A' Department in Orthopaedics and Trauma Surgery, 424 Military General Hospital, Thessaloniki, Greece
| | - Vasileios Lampridis
- A' Department in Orthopaedics and Trauma Surgery, 424 Military General Hospital, Thessaloniki, Greece
| | - Athanasios Badekas
- Orthopaedic and Trauma Department, Metropolitan Hospital, Athens, Greece
| |
Collapse
|
47
|
Suresh SS, Etemadi J, Bhatnagar G. "Soap Bubble" Lesion of the Middle Phalanx: Enchondroma or Epitheloid Hemangioma. J Orthop Case Rep 2014; 4:47-50. [PMID: 27298959 PMCID: PMC4719374 DOI: 10.13107/jocr.2250-0685.167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Epitheloid hemangioma, a benign vascular tumor that arises in skin and soft tissues can also involve the skeletal system. Occasionally this has been reported from small tubular bones of the hand. Case Report: Authors report a case of epitheloid hemangioma of the middle phalanx in a young girl without any cutaneous manifestations. The lesion presented as a swollen middle finger, and plain radiographs showed a geographic area of destruction with cortical thinning and intra lesional calcifications. The case was managed by curettage and bone grafting. Histology confirmed this as a case of epitheloid hemangioma. Conclusion: Epitheloid hemangioma should be considered in the differential diagnosis of hand masses with expansile lytic lesions with cortical thinning.
Collapse
Affiliation(s)
- S S Suresh
- Department of Orthopaedics, Ibri Regional Referral Hospital, PO Box 46, Ibri 516, Sultanate of Oman
| | - Jamshid Etemadi
- Department of Orthopaedics, Ibri Regional Referral Hospital, PO Box 46, Ibri 516, Sultanate of Oman
| | - Gunmala Bhatnagar
- Department of Orthopaedics, Ibri Regional Referral Hospital, PO Box 46, Ibri 516, Sultanate of Oman
| |
Collapse
|
48
|
Intraosseous angioleiomyoma the tibia: a case report. Pathol Res Pract 2014; 210:321-4. [PMID: 24635970 DOI: 10.1016/j.prp.2014.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 12/03/2013] [Accepted: 01/29/2014] [Indexed: 11/20/2022]
Abstract
Angioleiomyoma (vascular leiomyoma/angiomyoma) is a morphologically distinctive tumor characterized by proliferating smooth muscle cells admixed with prominent vascular elements. The majority of angioleiomyomas involve the superficial soft tissues. Examples of this lesion originating in bone, particularly in the appendicular skeleton, are extremely rare. The present report details the clinicopathologic features of an unusual case of an intraosseous angioleiomyoma arising in the distal tibia. The skeletal tumor exhibited the typical histologic appearance and immunophenotypic features of this entity. Due to its rarity, angioleiomyoma of bone can pose problems in diagnosis. Awareness that angioleiomyoma can present as a primary intraosseous lesion is important so as not to confuse this neoplasm with more commonly encountered bone tumors.
Collapse
|
49
|
Abstract
Vascular tumors of the bone represent a variety of neoplasms, ranging from benign hemangiomas and epithelioid hemangiomas to intermediate grade hemangioendotheliomas to frankly malignant angiosarcomas. Over the years, there has been considerable debate concerning the aggressivity, nomenclature, and mere existence of various nosologic entities, due to morphologic similarities and uncertainty regarding biologic behavior. Such debate has led to confusion among pathologists and clinicians, thus diminishing the prognostic implications in the diagnosis of these lesions. Here we review the current knowledge concerning the primary vascular neoplasms of the bone and correlate clinicopathologic features with tumor behavior.
Collapse
Affiliation(s)
- Jesse L Hart
- Department of Pathology, Emory University, Atlanta, Georgia
| | - Mark A Edgar
- Department of Pathology, Emory University, Atlanta, Georgia
| | - Jerad M Gardner
- Department of Pathology, University of Arkansas for Medical Sciences, 4301 W. Markham St, #517 Little Rock, Arkansas 72205.
| |
Collapse
|
50
|
Matsumoto Y, Takahashi Y, Haraguchi A, Okamoto T, Harimaya K, Matsunobu T, Endo M, Oda Y, Iwamoto Y. Intraosseous hemangioma arising in the clavicle. Skeletal Radiol 2014; 43:89-93. [PMID: 23990112 DOI: 10.1007/s00256-013-1715-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/06/2013] [Accepted: 08/08/2013] [Indexed: 02/02/2023]
Abstract
Intraosseous hemangioma (IH) is commonly seen in the vertebral column and skull: however, IH occurring in the appendicular skeleton, including the clavicle, is uncommon. We herein report the case of a 69-year-old female presenting with IH of the left clavicle. The findings of preoperative imaging studies, including radiographs, computed tomography (CT), magnetic resonance imaging, fluorine-18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT and ultrasonography, are described. In particular, (18)F-FDG PET/CT showed an ill-defined osteolytic lesion with abnormally high FDG uptake. Surgical en bloc resection with preoperative embolization was carried out and a histopathological examination confirmed the presence of an intraosseous cavernous hemangioma in the clavicle.
Collapse
Affiliation(s)
- Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan,
| | | | | | | | | | | | | | | | | |
Collapse
|