Intraosseous haemangioma

Case contributed by Dr Abeer Ahmed Alhelali

Presentation

History of non-tender forehead swelling which grew over the last 2 months. No history of trauma.

Patient Data

Age: 25-years-old
Gender: Male
CT

Well-defined expansive lytic lesion is seen affecting the right frontal bone with typical coarsened trabeculation and characteristic sunburst pattern radiating from the centre.

The erosive changes of the external skull table seen. An overlying focal galeal contour bulge was noted.

No intraparenchymal component could be depicted.  No soft tissue component could be seen.

No other similar lesions could be seen.

Case Discussion

Intraosseous hemangioma is accounting for about 0.7% of all bone tumors. It is considered as rare bone tumor. It can present at any age; however, it is commonly seen between fourth and fifth decades.​1

The cause is unknown; it could be congenital or traumatic. ​2

Patient may present with slow growing palpable hard mass as in our case with mild tenderness. Neurological deficit is uncommon as mass grows externally rather than internally.​3

Radiologically interosseous hemangioma presented as osteolytic lesion. CT is the modality of choice to check interosseous extent and soft tissue involvement; however, it is difficult to make definitive diagnosis radiologically only, as many differential diagnosis may be raised like langerhans cell histiocytosis, osteoma and fibrous dysplasia.​4

In CT fibrous dysplasia will show ground glass appearance which may help to differential between it and interosseous hemangioma which will show thickened trabeculae with sunburst pattern.

Treatment of choice is en bloc resection with safe margin of normal bone. Other therapies like embolization, curettage and radiotherapy may help.4

Special thanks to Dr.Tamer Ibrahim ElHoliby.

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Case information

rID: 50856
Case created: 24th Jan 2017
Last edited: 4th Feb 2017
Inclusion in quiz mode: Excluded

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