A rare case of pure primary hemangioma of the scapula: A case report

Abstract

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. IntroductionBone hemangiomas are benign lesions originating from new capillaries or cavernous vascular vessels located in the bone. They are characterized by an increased number of normal or abnormal blood vessels. Bone hemangiomas are initially asymptomatic, however, as the tumor grows local pain is often experienced (1). Degradation can occur during the growth of hemangioma (2). These rare, slow growing neoplasms may occur at any age, and account for ~1% of bone tumors (3-5). Hemangiomas may occur in any bone of the body, most commonly in the spine, craniofacial bone, skull, ribs and long bones (6-15); however, occurrence in the scapula is extremely rare. Hemangiomas of the long bone or flat bone commonly have a 'foam' or 'honeycomb' appearance (16-18). Bone hemangiomas disrupt the cortex and commonly grow expansively, which may result in the lesions being misdiagnosed as aggressive tumors or osteofibrous dysplasia and infectious processes (9,19). At present, treatments include radiotherapy, surgery and vascular embolization (1). In the present study, a rare case of a capillary hemangioma of the scapula, which proved difficult to diagnose, was presented.To the best of our knowledge, this is the first case of pure primary hemangioma of the scapula that was misdiagnosed as an osteofibrous dysplasia (20) and treated with surgery. Case reportIn June 2013, a 58 year-old female presented at the First Affiliated Hospital of Nanchang University (Nanchang, China) with intermittent/repeated left shoulder pain, which 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. The patient was referred to the Depa...

Dynamic magnetic resonance imaging features of cavernous hemangioma in the manubrium: A case report

“…Typically, hemangiomas present with high signal intensity on T2-weighted sequences and intermediate signal intensity on T1-weighted sequences due to its vascularity. If the amount of lipomatous soft tissue of the hemangioma increases, the signal intensity will increase on T1-weighted and T2-weighted sequences[ 5 , 6 ]. The use of an intravenous gadolinium contrast agent to image hemangiomas demonstrates various enhancement patterns.…”

“…The use of an intravenous gadolinium contrast agent to image hemangiomas demonstrates various enhancement patterns. Some hemangiomas present with a ‘‘bunch of grapes’’ appearance on T2- weighted sequences due to cavernous vascular spaces[ 6 ]. In addition, thrombi in hemangioma will show low signal foci within high-signal lesions on T2-weighed sequences[ 7 ].…”

Histological, epidemiological and anatomical analysis of 193 bone tumours of the scapula

“…In a large series of bone tumours including 566 patients, most of the lesions were found to originate from the femur (39.9%), the tibia (17.7%) and the humerus (11.8%), while the scapula was affected in 1.6% of cases only [2]. Due to the rarity of these lesions, there is a paucity of published literature [1], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]. Most of the articles are case reports or include a limited number of patients with a bone tumour of the scapula [1], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21].…”