Haemangioendotheliomas, along with haemangiopericytomas and angiosarcomas, are tumours that arise from vascular structures. In the case of haemangioendotheliomas, 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 haemangioendothelioma), 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 haemangiomas 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 tumour.
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 haemangiopericytomas.
The differential diagnosis for bone tumours is dependent on the age of the patient, with a very different set of differentials for the paediatric patient.
- bone-forming tumours
- cartilage-forming tumours
- chondromyxoid fibroma
- fibrous bone lesions
- bone marrow tumours
- other bone tumours or tumour-like lesions
- aneurysmal bone cyst
- benign fibrous histiocytoma
- giant cell tumour of bone
- Gorham massive osteolysis
- haemophilic pseudotumour
- intradiploic epidermoid cyst
- intraosseous lipoma
- musculoskeletal angiosarcoma
- musculoskeletal haemangiopericytoma
- primary intraosseous haemangioma
- simple bone cyst
- impending fracture risk
- 1. Murphy M. et al "Musculoskeletal Angiomatous Lesions" RadioGraphics: July 1, 1995 -- Volume 15, Number 4