Rare case of multiple aggressive vertebral hemangiomas

Mahajan, Parag Suresh; Jayaram, Abhilash Pulincherry; Negi, Vidya Chander

doi:10.4103/0976-9668.160030

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…In this case, as the lesions were particularly aggressive and osteoblastic in nature, the patient presented with increasing back and right leg pain, secondary to active lesion growth. While the lesions are often solitary, cases of multiple intraosseous hemangiomas have been reported, some of which have been extremely aggressive in nature [4,5]. Multiple symptomatic hemangiomas may present a diagnostic conundrum, as differential diagnoses of primary and metastatic bone tumors, as well as multiple myeloma, must be considered.…”

Section: Discussionmentioning

confidence: 99%

A case of multiple aggressive osseous hemangiomas on bone scan

Qaseem

Bermo

Matesan

et al. 2020

Radiology Case Reports

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A 49-year-old male with worsening back and right leg pain was referred for bone scan imaging. Bone scan demonstrated multifocal expansile osteoblastic bony lesions, atypical for benign osseous hemangiomas, which are commonly cold on bone scan. Multisite bone biopsies were compatible with the diagnosis of multifocal osseous hemangiomas. This case illustrates that aggressive osseous hemangiomas, a rare subtype of hemangiomas, may have variable osteoblastic activity on bone scan, ranging from mild to severe uptake.

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Section: Discussionmentioning

confidence: 99%

A case of multiple aggressive osseous hemangiomas on bone scan

Qaseem

Bermo

Matesan

et al. 2020

Radiology Case Reports

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“…On MRI of an asymptomatic hemangioma, due to the presence of abundant fatty tissue and high vascularity, it is observed in hyper intense in T1. If fat becomes aggressive, the vascularity reduces; as a result T1 turns into hypo and T2 to hyper (5,6,10). CT scan is the gold standard to diagnose hemangioma and shows the extent of the body involvement and posterior elements, the number of vertebrae involved and the presence of cord compression (4).…”

Section: Discussionmentioning

confidence: 99%

“…They are usually asymptomatic and incidentally discovered; 0.9% -1.2% of cases are symptomatic and called aggressive hemangiomas. Symptoms may vary from neurological deficits in 45% of the cases to simply pain in the remaining 55% (1,4,5). Symptomatic hemangiomas, especially with neurological involvement, usually occur in the thoracic area whereas asymptomatic cases are usually in the lumbar region (6).…”

Section: Introductionmentioning

confidence: 99%

Aggressive Hemangioma of the Thoracic Spine with Cord Compression: A Case Report

Zaraei¹,

Vahar²,

Firoozabadi³

et al. 2017

J Orthop Spine Trauma

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Vertebral hemangiomas are common neoplasms of the spine and usually considered benign. They are usually asymptomatic and incidentally detected. A rare subset of them, referred to as aggressive hemangiomas, can be symptomatic presented with pain and neurological symptoms. The current study presented a case of a 27-year-old female with a four-month history of pain in thoracic spine and neurological involvement of the lower limbs for three weeks before the visit. Further investigations with computed tomography (CT) scan and magnetic resonance imaging (MRI) showed aggressive hemangioma in T4 vertebra with cord compression. The patient underwent laminectomy of T4, posterior fixation of T2-T6 and vertebroplasty. Final pathologic diagnosis after surgery confirmed the diagnosis of vertebral hemangioma. One month after surgery, the patient's motor symptoms and three months later, sensory symptoms were resolved.

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“…Osteoporosis was identified by bone densitometry with a T-score of -2.5 or lower [7], and the diagnosis of all the vertebral haemangiomas was made by corroborating MRI findings with findings on other imaging modalities, i.e. by a parallel striated pattern (corduroy cloth) on plain film or a spotted appearance (polka dot) on axial CT images [8].…”

Section: Standard Of Referencementioning

confidence: 99%

Role of diffusion-weighted magnetic resonance imaging in the evaluation of vertebral bone marrow lesions

Kaur¹,

Thukral²,

Khanna³

et al. 2020

Pol J Radiol

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Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating vertebral marrow pathologies. To determine the sensitivity, specificity, and threshold apparent diffusion coefficient (ADC) values that can aid in the differentiation of malignant from benign bone marrow lesions. Material and methods: This observational study included 100 patients, who underwent MRI examination with a 1.5 Tesla scanner. The ADC values of normal and pathological vertebrae were estimated, and the threshold ADC values were computed by receiver operating characteristic (ROC) analysis. The results were correlated with histopathological diagnosis, clinical follow-up, and other investigations. Statistical analysis was done by employing unpaired two-tailed Student's t-test and the p-value of < 0.05 was deemed as statistically significant. Results: Vertebral bone marrow lesions had a male predominance and there was a predilection towards thoracic and lumbar vertebrae, with L4 being the commonest. Metastasis was the commonest lesion, followed by spondylodiscitis. The mean ADC value of benign pathologies was significantly greater than malignant pathologies (p < 0.05). The threshold value for the demarcation between benign and malignant pathologies was computed to be 1.21 × 10-3 mm 2 /s. DW imaging had sensitivity of 100%, specificity of 92.31%, positive predictive value of 87.5%, and negative predictive value of 100%. Conclusions: Vertebral marrow lesions can be differentiated as benign or malignant with good sensitivity and specificity with the help of DW-ADC maps.

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Rare case of multiple aggressive vertebral hemangiomas

Cited by 11 publications

References 14 publications

A case of multiple aggressive osseous hemangiomas on bone scan

A case of multiple aggressive osseous hemangiomas on bone scan

Aggressive Hemangioma of the Thoracic Spine with Cord Compression: A Case Report

Role of diffusion-weighted magnetic resonance imaging in the evaluation of vertebral bone marrow lesions

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