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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Smith E, Rajakulasingam R, Davies AM, James SL, Botchu R. Answer To Test Yourself Question: Right medial hip pain. Skeletal Radiol 2021; 50:1271-1272. [PMID: 33241439 DOI: 10.1007/s00256-020-03679-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 10/23/2020] [Accepted: 11/15/2020] [Indexed: 02/02/2023]
Affiliation(s)
- E Smith
- Department of Musculoskeletal Imaging, Royal Orthopaedic Hospital, Birmingham, UK
| | - R Rajakulasingam
- Department of Musculoskeletal Imaging, Royal National Orthopaedic Hospital, Stanmore, UK
| | - A M Davies
- Department of Musculoskeletal Imaging, Royal Orthopaedic Hospital, Birmingham, UK
| | - S L James
- Department of Musculoskeletal Imaging, Royal Orthopaedic Hospital, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Imaging, Royal Orthopaedic Hospital, Birmingham, UK.
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Cao L, Wen JX, Han SM, Wu HZ, Peng ZG, Yu BH, Zhong ZW, Sun T, Wu WJ, Gao BL. Imaging features of hemangioma in long tubular bones. BMC Musculoskelet Disord 2021; 22:27. [PMID: 33407312 PMCID: PMC7786894 DOI: 10.1186/s12891-020-03882-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022] Open
Abstract
Background To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. Methods Twenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5]. Results Among 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI. Conclusions The long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.
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Affiliation(s)
- Lei Cao
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Jin-Xu Wen
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Shu-Man Han
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Hui-Zhao Wu
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Zhi-Gang Peng
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Bao-Hai Yu
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Zhi-Wei Zhong
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Tao Sun
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
| | - Wen-Juan Wu
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China.
| | - Bu-Lang Gao
- Department of Radiology the Third Hospital, Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei Province, China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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Abstract
Intraosseous hemangiomas are rare, benign bone tumors usually affecting the bones of the axial skeleton. Its incidence in the long bones is extremely rare. We report a 19-year-old boy with solitary intraosseous hemangioma of the proximal ulna. Radiographs and computed tomography images showed a well-defined osteolytic lesion involving the right proximal ulna. Magnetic resonance imaging showed intermediate signal intensity on T1-weighted images and increased signal intensity on T2-weighted images with internal trabeculae and peripheral post-contrast enhancement. Postcurettage histologic diagnosis of intraosseous hemangioma was made.
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Affiliation(s)
- Sumer Shikhare
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun, Singapore
| | | | - Wilfred Peh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Trishna Shimpi
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun, Singapore
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Affiliation(s)
- Lauren M Ladd
- Department of Radiology and Imaging Sciences, Indiana University Health, Indiana University School of Medicine, Indianapolis, IN.
| | - Trenton D Roth
- Department of Radiology and Imaging Sciences, Indiana University Health, Indiana University School of Medicine, Indianapolis, IN
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Eajazi A, Kheterpal A, Kattapuram S, Nielsen GP, Rosenthal DI. Multiple giant cell tumors of bone arising from multiple fatty tumors. Skeletal Radiol 2017; 46:117-121. [PMID: 27771752 DOI: 10.1007/s00256-016-2498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/19/2016] [Accepted: 09/22/2016] [Indexed: 02/02/2023]
Abstract
We describe a patient with a history of giant cell tumor who over the course of 18 years developed multiple fat containing osseous lesions in the pelvis and spine. Two of these lesions subsequently evolved into biopsy proven giant cell tumor of bone. To our knowledge, this phenomenon of giant cell tumors evolving from fat containing lesions has not been described.
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Affiliation(s)
- Alireza Eajazi
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Arvin Kheterpal
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Susan Kattapuram
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Gunnlaugur Petur Nielsen
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Warren 2, 55 Fruit Street, Boston, MA, USA
| | - Daniel Ira Rosenthal
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
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Abstract
Intraosseous haemangiomas (IOHs) are benign vascular bone tumours that account for 1% of all primary bone tumours. They are most frequently seen in the vertebrae and skull, and are rarely found in long bones. Herein, we present an uncommon case of a 25-year-old woman with a solitary IOH that occupied the left femoral neck. We describe the clinical, radiological and histological details of the case, as well as the three-year outcome of the surgical treatment, which successfully preserved the femoral head. We also conducted a review of the literature on this uncommon entity.
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Affiliation(s)
- Zhan Xia
- Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
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Li W, Zou F, Dai M, Zhang B, Nie T. A rare case of pure primary hemangioma of the scapula: A case report. Oncol Lett 2015; 10:2265-2268. [PMID: 26622831 DOI: 10.3892/ol.2015.3596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 05/12/2015] [Indexed: 01/25/2023] Open
Abstract
Hemangioma is a benign vascular tumor, which may occur in any bone of the body. The most common locations are the spine and craniofacial bone; however, occurrence is extremely rare in the scapula. The current study presented the case of a 58-year-old female, with scapula hemangioma in the left shoulder who presented with joint ache that had lasted for ~1 year. The main clinical manifestations included local tenderness, an osseous lump and limited shoulder movement with a little pain, which was alleviated by rest. Roentgenogram, computed tomography and magnetic resonance imaging of the left acromion revealed a mass along the inner surface of the scapula of the left shoulder with polycystic expansion and bone destruction. The results of computed tomography and magnetic resonance imaging indicated a pure primary tumor and the lesion was subsequently resected. Notably, the postoperative pathological diagnosis was capillary hemangioma. The aim of the present study was to analyze the clinical and imaging features of scapula hemangioma, which must be considered for the differential diagnosis of scapula tumors. In the present case, no recurrence was identified by X-ray examination 1 year after surgery. The long-term efficacy of surgical treatment requires continuous observation of the patient.
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Affiliation(s)
- Wei Li
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Fan Zou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Bin Zhang
- Multidisciplinary Therapy Center of Musculoskeletal Tumor, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Tao Nie
- Multidisciplinary Therapy Center of Musculoskeletal Tumor, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Abstract
Intraosseous haemangiomas (IOHs) are benign vascular bone tumours that account for 1% of all primary bone tumours. They are most frequently seen in the vertebrae and skull, and are rarely found in long bones. Herein, we present an uncommon case of a 25-year-old woman with a solitary IOH that occupied the left femoral neck. We describe the clinical, radiological and histological details of the case, as well as the three-year outcome of the surgical treatment, which successfully preserved the femoral head. We also conducted a review of the literature on this uncommon entity.
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Affiliation(s)
- Zhan Xia
- Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
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Hwang SW, Lee JH, Ryu JA, Choi JM, Lee SK, Kim HS, Kim TS, Kim TH, Lee HS, Bang SY. Diffuse Skeletal Hemangiomatosis Mimicking Sacroiliitis. J Rheum Dis 2014. [DOI: 10.4078/jrd.2014.21.4.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Soon Woo Hwang
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jung Hoon Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Ah Ryu
- Department of Radiology, Hanyang University College of Medicine, Seoul, Korea
| | - Jong Min Choi
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Ki Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Sung Kim
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Tai-Seung Kim
- Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Hwan Kim
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye-Soon Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - So-Young Bang
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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Ko SW, Park JG. Cavernous hemangioma of the ilium mimicking aggressive malignant bone tumor with increased activity on (18)F-FDG PET/CT. Korean J Radiol 2013; 14:294-8. [PMID: 23482507 PMCID: PMC3590343 DOI: 10.3348/kjr.2013.14.2.294] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 09/17/2012] [Indexed: 12/05/2022] Open
Abstract
Osseous hemangioma is a benign vascular tumor, and it usually occurs in the vertebrae and the skull. However, hemangiomas of flat bones are rare, and there are very few reports that describe the radiologic findings of osseous hemangioma of the ilium. We report a unique case of large cavernous hemangioma mimicking a chondrogenic malignant bone tumor originated from the ilium in a 22-year-old female. The mass showed stippled calcifications, heterogeneous enhancement with thick septa and enhanced soft tissue components on CT and MR, and also this mass demonstrated heterogeneous 2-fluoro [fluorine-18]-2-deoxy-D-glucose (18F-FDG) uptake on 18F-FDG PET/CT.
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Affiliation(s)
- Seog Wan Ko
- Department of Diagnostic Radiology, Dong-A Hospital, Gwangju 503-300, Korea.
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Rigopoulou A, Saifuddin A. Intraosseous hemangioma of the appendicular skeleton: imaging features of 15 cases, and a review of the literature. Skeletal Radiol 2012; 41:1525-36. [PMID: 22736082 DOI: 10.1007/s00256-012-1444-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 03/06/2012] [Accepted: 05/06/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We performed a retrospective study of the imaging findings of 15 patients (nine female, six male, mean age 43 years) with the histopathological diagnosis of hemangioma. MATERIALS AND METHODS Radiographs, magnetic resonance imaging (MRI), computed tomography, and bone scan were performed. RESULTS Lower extremity was involved in nine cases, upper extremity in three cases, the acetabulum in two cases and the ilium in one case. Fourteen of the lesions were intramedullary and one was subperiosteal. Radiographs identified the lobular osteolytic intramedullary lesions with sclerotic margins (eight cases) and coarse linear trabeculation (four cases) or matrix ossification (one case) within it or a heavily calcified lesion (one case). Lesion expanded and breached the cortical cortex in four cases. The subperiosteal hemangioma presented as a soft tissue mass with proximal periosteal reaction. MRI also identified the soft tissue mass in the case of the subperiosteal hemangioma. The CT scan demonstrated the lobular osteolytic lesions, the prominent trabeculation and matrix mineralization and evaluated the cortex. In all six cases, the lesion showed increased uptake in the bone scan. CONCLUSIONS This is the largest reported series of imaging features of intraosseous hemangiomas of appendicular skeleton. The lesion should be differentiated from other chondral or expansile lytic tumors. The final diagnosis can only be confirmed by histopathology.
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Affiliation(s)
- Aspasia Rigopoulou
- Department of Radiology, University Hospital of Patras, 26504, Rio, Patras, Greece.
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Abstract
UNLABELLED A 23-month-old girl was referred to us because of a right leg limp for 10 days that had not improved despite anti-inflammatory treatment and that did not show signs of infection. Upon examination, gait was in abduction and external rotation of the hip. Plain radiographs showed a solitary lucent lesion of the posteroinferior two thirds of the epiphysis that was hyperintense on T2-weighted magnetic resonance scanning images. We approached the proximal femoral epiphysis using the "trapdoor" technique and excised the lesion by curettage and iliac crest graft. Histologically, the lesion was diagnosed as an enchondroma. We discuss the main causes of lucent epiphyseal lesions in children. Finally, we review the literature on previous reports of patients with solitary epiphyseal enchondromas. STUDY TYPE Case report.
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Abstract
We present the case of a 35-year-old man with a hemangioma in the iliac wing that simulated an aggressive bone lesion on CT, MRI, and bone scintigraphy. On CT, the lesion, 12 cm in in maximum dimension, was expansile and septated. On MRI, the lesion was isointense with respect to muscle on T1 weighted images, and hyperintense on T2 images, with focal regions of cortical breach. Radionuclide bone scan showed increased tracer accumulation. The diagnosis was made following surgical biopsy, and the lesion was treated conservatively.
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