Epithelioid hemangioma of bone

Abstract

Although no specific radiographic appearance has emerged to date for the epithelioid subtype of hemangioma, these lesions most typically exhibit well-defined osteolysis. Other relatively common features include surrounding sclerosis, cortical expansion and cortical destruction. We present a case of epithelioid hemangioma of the spine with an unusual radiological appearance which to our knowledge has not previously been reported: diffuse sclerosis of the involved vertebral body. The diffuse sclerosis seen in this case resembles the osteosclerotic process seen not only in benign entities such as subacute and chronic osteomyelitis, but also in malignant lesions such as osteoblastic metastatic disease and lymphoma.

Epithelioid Hemangioma Involving Three Contiguous Bones: a Case Report with a Review of the Literature

“…1C-G). However, our lesion contained scattered tiny calcifications and internal trabeculations consistent with the findings in Ling et al (7). The remainder of the vertebral body in our case showed normal vertebral density, which differed from the report by Ling et al (7).…”

“…As described by O'Connell et al (4), five out of 10 cases of epithelioid hemangioma showed complete osteolytic lesions with well-defined sclerotic borders; the remaining five cases showed a mixed lytic and sclerotic appearance with partial cortical destruction and thick periosteal reactive bone formation. Ben Romdhane et al (5) and Rosai et al (6) also reported well-defined lesions with sclerotic margins, while Ling et al (7) described a diffuse sclerotic lesion. Our case is distinct from others because 1) the lesion involves three bones in contiguity: the T10 and T9 vertebral bodies including the left 10th rib, 2) two patterns of bone destruction were detected from a plain radiograph: the geographic (in the vertebral bodies) and the permeative osteolytic lesion (of the 10th rib), and 3) our case showed cortical bone destruction accompanied by a soft tissue component, but without a definite periosteal reaction.…”

“…Regarding the findings of epithelioid hemangioma by CT scan, Ling et al (7) reported that a contrast-enhanced CT scan revealed an expanding lytic lesion involving the right anterolateral aspect of the T7 vertebral body. The lesion had a thin ossification rim at its extraosseous periphery, and also contained scattered calcifications and residual trabeculae.…”

Epithelioid Hemangioma of Bone Revisited

“…It has been most extensively documented in the skin and subcutis, and has also been described in bone, lymph nodes, lung, penis, eye, tongue, breast, arteries, colon, heart, spleen, and testis. 2,4,10,15,19,[22][23][24]26,[31][32][33]36 On the basis of reports, the skeleton is probably the second most common location for this neoplasm to develop. Interestingly, similar tumors have been described in several animal species.…”

Spinal Epidural Epitheloid Hemangioma – Case Report and Review of the Literature

“…Controversy exists regarding its true nature as a neoplasm, some workers suggesting it to be a reaction to trauma [4, 5]. Though commonly described as cutaneous lesions, they have also been reported in the tongue, lymph nodes, bone, testes, ovaries, nerves and the heart [4,5,6]. Purely non-osseous extradural epitheloid hemangioma has not been documented.…”