Hemangioendotheliomas, along with hemangiopericytomas and angiosarcomas, are tumors that arise from vascular structures. In the case of hemangioendotheliomas, the cell of origin is the endothelial cell, and they range from benign to frankly malignant lesions.
They typically occur in young patients.
They occur especially in the soft tissues of the limbs and are often closely related to veins, from which they are thought to arise.
Less frequently they can arise in bone (osseous hemangioendothelioma), in which case they are most often seen in the calvaria, spine or lower limbs.
Nonspecific soft tissue mass. When involving bone, they are predominantly lytic, and may mimic hemangiomas with a coarse honeycomb appearance.
Dense, well-circumscribed areas of enhancement with early draining veins and shunting. Hemangiopericytomas are described as having a pedicle formed by the arteries supplying the tumor from which vessels branch to encircle the tumor.
Non specific soft tissue mass, with density similar to muscle but demonstrating bright contrast enhancement. CTA may demonstrate large feeding vessels.
Brightly enhancing soft tissue mass, often hyperintense on T2WI, with prominent flow voids, most marked in hemangiopericytomas.
- 1. Murphy M. et al "Musculoskeletal Angiomatous Lesions" RadioGraphics: July 1, 1995 -- Volume 15, Number 4
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The differential diagnosis for bone tumors is dependent on the age of the patient, with a very different set of differentials for the pediatric patient.
- bone-forming tumors
- cartilage-forming tumors
- bizarre parosteal osteochondromatous proliferation (Nora lesion)
- chondromyxoid fibroma
- juxtacortical chondroma
- fibrous bone lesions
- bone marrow tumors
- other bone tumors or tumor-like lesions
- aneurysmal bone cyst
- benign fibrous histiocytoma
- giant cell tumor of bone
- Gorham massive osteolysis
- haemophilic pseudotumor
- intradiploic epidermoid cyst
- intraosseous lipoma
- musculoskeletal angiosarcoma
- musculoskeletal hemangiopericytoma
- primary intraosseous hemangioma
- post-traumatic cystic bone lesion
- simple bone cyst
- impending fracture risk