Document Detail

Solitary skeletal hemangioma of the extremities.
MedLine Citation:
PMID:  11000295     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report the clinicopathologic features of solitary skeletal hemangioma of the extremities and to review previous cases in the English language medical literature. PATIENTS: In addition to five of our own cases, 34 literature cases with substantial and 75 with partial clinicopathologic information were found. RESULTS: Our patients, three men and two women, ranged in age from 37 to 83 years (mean 65.6 years). The lesion was an incidental radiologic finding in two patients, while three were symptomatic. In no case was a correct preoperative radiologic diagnosis made, a malignant process being considered as a possibility in all. The hemangiomas were medullary; two involved a metacarpal, two the fibula, and one the humerus. In contrast, previously reported patients were younger (mean age 32 years), predominantly female (60%), and symptomatic in over 90% of cases. The lesion is rare in those younger than age 10 years or older than age 60 years. As in our patients, the long bones are most frequently involved (75%), with the diaphysis or metadiaphysis, as in four of our patients, the most common locations. Although 20% of cases occur in the hands or feet, metacarpal involvement is rare. Medullary origin, as in all of our cases, is most frequent, but 45% of cases are either periosteal (33%) or intracortical (12%). In the literature, cavernous hemangioma is the most frequent type. Three of our hemangiomas were cavernous, one capillary, and one venous, the latter being rarely reported in extremity bones. CONCLUSIONS: Due to the diversity of radiologic patterns produced by skeletal hemangioma, a correct preoperative diagnosis is rarely made. Almost all patients do well, even those with less than complete removal of the lesion; local recurrence is rare. All of our patients were well following either therapeutic or simple diagnostic procedures. Due to the destructive nature of some biopsy procedures, the histologic diagnosis of hemangioma may at times also be problematic.
Z Kaleem; M Kyriakos; W G Totty
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Skeletal radiology     Volume:  29     ISSN:  0364-2348     ISO Abbreviation:  Skeletal Radiol.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-30     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7701953     Medline TA:  Skeletal Radiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  502-13     Citation Subset:  IM    
Division of Surgical Pathology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
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MeSH Terms
Aged, 80 and over
Bone Neoplasms / diagnosis*
Diagnosis, Differential
Fibula / pathology,  radiography
Hemangioma / diagnosis*
Humerus / pathology,  radiography
Magnetic Resonance Imaging
Metacarpus / pathology,  radiography
Middle Aged
Tomography, X-Ray Computed

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