Intraosseous Hemangioma Research Articles

A RARE LOCALIZATION OF INTRAOSSEOUS HEMANGIOMA: CASE REPORT

Hemangiomas are defined as benign neoplasms originating from vascular endothelial tissue. Intraosseous hemangiomas are very rare and account for less than 1% of bone tumors. They are mostly seen in vertebras, skull bones and long bones. Intraosseous hemangiomas are very rare in jaws. Intraosseous hemangiomas are typically asymptomatic and grow slowly. In this case report, asymptomatic intraosseous hemangioma was found in the mandible and the patient was evaluated clinically, radiologically and histopathologically. A-69-year old male patient was referred to our clinic with a multilocular lesion. CBCT and MRI were evaluated for further examination. Histopathological examination revealed intraosseous hemangioma in the mandible. 

INTRAOSSEOUS CAVERNOUS HEMANGIOMA OF MANDIBLE : A RARE CASE REPORT

Intraosseous hemangiomas, mainly of the jaw bones are quite uncommon lesions (0.5-1%) of all intraosseous tumors. They are most commonly seen in second decade of life with a higher female predilection (2:1). The most common sites of occurrence are skull and vertebral column and rarely seen in the mandible. The origin of hemangiomas is still debatable. Hemangiomas are rare benign vasoformative neoplasms of endothelial origin. They usually present as a rm, painless swelling of the jaw bone with or without facial asymmetry. Cavernous hemangioma poses a diagnostic dilemma and mimics lesions like ameloblastoma, central giant cell granuloma, osteosarcoma, brous dysplasia . Here we are presenting a case report of a 28 year old female with intraosseous cavernous hemangioma of right body of mandible which was treated surgically and followed by reconstruction.

Intraosseous Hemangioma of Nasal Bone: Unusual Location of a Common Tumor with Literature Review

Hemangiomas are very common benign vascular tumors of head and neck. Intraosseous hemangiomas are rare and very few cases of involvement of nasal bone have been found in literature. A slowly growing hard nasal mass should draw clinical suspicion and should be included in differential diagnosis as it carries with it the risk of uncontrollable hemorrhage during surgical procedures. Clinical examination and radiology are contributory but histopathological examination is confirmatory for diagnosis.
 Keywords: hemangiomas, intraosseous, nasal bone

INTRAOSSEOUS CAVERNOUS HEMANGIOMA OF THE MANDIBLE: A CASE REPORT

<h3>Background</h3> Soft tissue hemangiomas are common benign vascular lesions, especially in the first decade of life. However, intraosseous hemangiomas (IHs) are very rare and comprise less than 1% of all hemangiomas. The vertebrae and long bones are common localizations for IH. They are rarely seen in the jaw and the mandible is affected 3 times as commonly as the maxilla. Here, a case of IH of the mandible is presented because of its rarity and diagnostic difficulty. <h3>Case Report</h3> A 60-year-old male patient was admitted to the Department of Head and Neck Surgery with a complaint of painless swelling in the anterior part of mandible. There were only 4 teeth in the mandible on physical examination of the patient's oral cavity. The patient was evaluated with panoramic radiography. Radiological findings were interpreted as an irregularly contoured, cystic-lytic lesion in the mandible that resulted in deformation and swelling in the mental zone. There was no feature in the patient's history. The surgeon decided on mandibular resection because the cystic-lytic lesion was suspicious for malignancy. Pathologic examination of resection specimen revealed blood-filled and thin-walled vascular spaces between the bone trabeculae. Focally intravascular papillary formations with fibrous stalks were detected. Mitotic activity, necrosis, and atypia were not seen in endothelial and stromal cells. According to pathologic findings, the case was reported as "intraosseous cavernous hemangioma." <h3>Conclusions</h3> The possibility of IH should be considered by clinicians and pathologists in cystic-lytic lesions of the mandible. Histopathology is the gold standard for exclusion of malignant lesions and for correct diagnosis.

Intraosseous Hemangioma of the Zygoma: A Case Report

Intraosseous hemangioma is a rare, benign vascular tumor of endothelial origin. It accounts for fewer than 1% of all hemangiomas, and very rarely occurs in the face. Intraosseous hemangioma usually presents as an asymptomatic lesion, but symptoms can occur due to the mass effect. The authors describe a case of intraosseous hemangioma of the zygoma with a review of the relevant literature. A 44-year-old man presented with a chief complaint of painless swelling on the left zygomatic region that had been slowly growing for the past year. On physical examination, a hard, non-movable mass in a deep layer was palpated. On computed tomography performed to evaluate its layers and extent, trabeculation was found inside the mass, but the lack of destruction of the surrounding bone suggested that the mass was benign. Complete surgical excision was performed under local anesthesia. After complete excision of the mass, slight erosions remained on the cortical bone of the zygoma, but because it was small enough not to cause a facial deformity such as depression or asymmetry, no additional reconstructive procedure was performed. There were no symptoms or recurrence during a 8-month follow-up period. Key Words: Intraosseus, Hemangioma, Zygoma

Intraosseous Hemangioma of the Ethmoid Sinus.

Intraosseous hemangiomas, also referred to as bony hemangiomas, arising within the nasal cavity are exceedingly rare with only 2 cases arising in the ethmoid region. Despite their rarity, they are important to consider in a patient presenting with long-standing nasal congestion. While characteristic findings on computed tomography imaging may be observed, biopsy is diagnostic. En bloc resection using a transnasal endoscopic approach with or without preoperative embolization is the treatment of choice for intranasal intraosseous hemangiomas.

Quantitative bone SPECT/CT applications for primary bone neoplasms.

To evaluate the clinical utility of quantitative values obtained with bone single photon emission computed tomography/computed tomography (SPECT/CT) for primary bone neoplasms. Bone SPECT/CT scans of 23 patients with 19 benign bone neoplasms (5 osteoid osteomas, 4 bone giant cell tumor, 4 osteofibrous dysplasia, 3 intraosseous ganglion, 2 aneurysmal bone cyst, 1 intraosseous hemangioma) and 5 malignant bone neoplasms (2 osteosarcoma, 1 periosteal osteosarcoma, 1 malignancy in bone giant cell tumor, 1 Ewing sarcoma) were retrospectively analyzed with maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), mean SUV (SUVmean), metabolic bone volume (MBV), and total bone uptake (TBU) of primary lesions. Mean SUVmax of 19 benign and 5 malignant primary bone neoplasms were 6.89±3.26 (range 3.9-15.13) and 10.31±3.19 (5.0-13.45) respectively, with statistically significant difference (P=0.048). Mean SUVpeak of those were 5.87±2.83 (range 3.5-13.63) and 9.18±3.05 (4.09-12.03) respectively, with statistically significant difference (P=0.032). Mean SUVmean of those were 4.43±2.11 (range 2.59-9.37) and 7.13±2.90 (3.3-10.42) respectively, with statistically significant difference (P=0.027). Mean MBV of those were 22.0±30.0 (range 2.47-110.61) and 27.8±39.94 (8.59-99.24) respectively, with no statistically significant difference (P=0.72). Mean TBU of those were 80.64±94.57 (range 10.50-373.57) and 166.60±203.97 (28.68-528.13) respectively, with no statistically significant difference (P=0.17). Quantitative values obtained with bone SPECT/CT may serve as osteoblastic biomarkers for primary bone neoplasm.

Aggressive Diffuse Intraosseous Hemangioma: Case Report.

Vertebral hemangioma is a benign vascular tumor that is usually asymptomatic and is discovered incidentally on imaging. When symptomatic, the most frequent presentation occurs in the form of vague back pain of insidious onset and, in rare cases, may be associated with root or spinal compression, causing sensory and motor deficits. The authors report the case of a 33-year-old man, previously healthy, with a diagnosis of thoracic spine hemangioma at multiple levels, in the sternum, in the scapula and in the costal arches; all lesions were symptomatic, and surgical intervention was required; one of the lesions at the thoracic spine level evolved with spinal compression and acute neurological deficit, requiring urgent surgical intervention. Intraosseous hemangiomas represent < 1% of all bone tumors, having few reports of multifocal presentation in the axial and appendicular skeleton. In the literature review, no other case of aggressive multifocal intraosseous hemangioma with this presentation was found, including associated neurological symptoms in the same case.

CD 34 Staining to the Rescue in an Incidental Capillary Hemangioma of the Bone Marrow.

Intraosseous hemangiomas are extremely rare and benign neoplasms of vascular origin, usually occurring in adults and involving skull bones, vertebra, ribs, sternum, long bones, patella and clavicle. Iliac or pelvic bone involvement is extremely rare. Hemangiomas of the marrow spaces are extremely uncommon. We report this rare neoplasm in a child that was incidentally detected on bone marrow examination for thrombocytopenia which mimicked a metastatic deposit. However, immunostaining with CD34 was successful in characterizing this solid vascular lesion as capillary hemangioma. This report emphasizes the importance of correctly identifying this lesion with the help of simple CD34 immunostaining since no specific therapy is required.

Calvarial lesions: overview of imaging features and neurosurgical management

Calvarial lesions are rare and can present as a variety of different diseases. The lesions can be palpable on the skin and cause local pain and paraesthesia and, depending on the location, neurological deficits can also occur. This research aims to present an overview of typical imaging features as well as neurosurgical management. We examined the charts of patients who underwent surgery on a calvarial lesion in our department between 2004 and 2017 (n=133). Retrospectively, the pre-, intra-, and postoperative data were analyzed with morphological and histological findings and compared with each other. Pain, swelling, cosmetically disturbing, and neurological deficits were the main complaints. Seventy-seven lesions were limited to the bone, while another 56 lesions showed an infiltrating growth in the adjacent tissue. Depending on the clinical signs and suspected diagnosis, a biopsy, a partial removal, or a complete resection was performed. Histiocytosis (n=20), meningiomas (n=20), metastases (n=19), and osteomas (n=16) were the most common lesions. Fibrous dysplasia (n=6) and intraosseous hemangioma (n=9) were less common; other lesions were present only in isolated cases. Imaging features may suggest the lesion to be benign or malignant, but the diagnosis can be only confirmed by histological examination. The surgical strategy depends on the complaints, location of the lesion, and suspected diagnosis. Adjuvant treatment should be initiated according to the histological findings.

Central hemangioma of Zygoma - A rare case report with CT and MRI features

Intraosseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. The involvement of the facial bones is rare, and if occurs, it can involve maxilla, mandible, nasal bones and zygomatic bone. Zygomatic hemangioma is a benign, slow-growing tumor occurring mostly in adult women. The radiographic findings are diagnostic. Total excision of the tumor with the primary reconstruction of the defect is the preferred treatment modality. Here, we are reporting a case of a 37-year-old woman who presented with a painless hard swelling in the right zygomatic prominence, which was diagnosed as intraosseous hemangioma after the radiological examination because of its characteristic radiological picture. An Excisional biopsy also proved the swelling to be a cavernous hemangioma.

Vertebral Hemangiomas: Polka-dot and Corduroy Sign

Clinical Image Vertebral hemangiomas are mal-formative benign tumours consisting of newly formed normal blood vessels without arteriovenous shunt. It has two main histopathological types, cavernous and capillary angiomas. The exact etiology of spinal hemangiomas genesis is not well understood yet, a well-known characteristic of these lesions includes a vascular proliferation of capillaries, subsequently leads to displacement of bone and in rarer cases erosion into the spinal canal. In 1% of cases, the tumour can be locally aggressive, revealed by neurological complications thus requiring a surgical intervention. The development of this vascular malformation causes osteolysis of cancellous bone and its replacement by coarse, sclerotic trabeculae surrounded by fatty marrow or vascular spaces, creating a vertically striated appearance (Figures 1A and 1B) due to thickening of the bony trabeculae. This radiological aspect isreferred to as the jail bar sign, also known as the corduroy sign. The polka-dot sign is the result of the same phenomenon happening in vertebral intraosseous hemangiomas. It is the axial equivalent of the corduroy sign seen on sagittal and coronal images. On CT scan the dots are white on a black fatty background bearing a likeness to a polka-dot pattern (Figure 1C). Keywords: Vertebral hemangiomas, Polka-dot sign, Corduroy sign Declaration of Interests: The authors declare that they have no competing interests.

Intraosous Angioma of the Ocular Orbit Histologically Benign, Clinically Malignant Tumor about a Case Review and Analysis of the Bibliography

Although the primary intraosseous angioma or hemangioma, although it rarely affects the bones of the orbit, it should be taken into account in the differential diagnosis in those patients who present a fixed mass in the orbit or signs of progressive proptosis, sometimes not painful. For the therapeutic approach, it is critical to assess the exact location and extent of the lesion by CT and MRI, and to establish whether it has a vascular origin, since improper management can lead to severe bleeding. Surgical treatment is indicated for progressive proptosis or cosmetic deformity. We present the case of a patient with primary intraosseous hemangioma of the supralateral rim of the orbit, we review the bibliography of this very low prevalence disease and we trust that in this way, we contribute to the casuistry.

Orbitofrontal Reconstruction With a Three-Dimensional Titanium Patient-Specific Implant After Intraosseous Haemangioma Resection

Intraosseous hemangiomas are rare benign tumors that can develop in the skull. Orbitofrontal localization is uncommon. The complexity of orbitofrontal anatomy results in difficult reconstruction following trauma or tumoral resection. A 50-year-old woman with a right orbitofrontal intraosseous hemangioma was referred to our department. The authors decided to perform tumoral bone resection and orbitofrontal reconstruction using virtual surgical planning in collaboration with Materialize engineers (Materialise, Leuven, Belgium). Three cutting guides and a patient-specific 3-dimensional (3D) titanium implant were designed and manufactured in 3 weeks. Surgery was performed with a double surgical team composed of maxillofacial surgeons and neurosurgeons. No perioperative or post-operative complications occurred. Post-operatively, the patient was completely asymptomatic and clinical examination showed symmetrical and satisfactory facial morphology. Virtual surgical planning, design of patient-specific guides and manufacturing of implants make surgery easier and increase surgical precision. This technique is recommended for wide use in cases of oncological or complex trauma craniomaxillofacial reconstruction.

A rare proximal tibial intraosseous hemangioma treated with en bloc resection and total knee arthroplasty: a case report

A rare proximal tibial intraosseous hemangioma treated with en bloc resection and total knee arthroplasty: a case report

Hemangioma of long tubular bone: imaging characteristics with emphasis on magnetic resonance imaging.

To investigate the imaging findings, especially the MRI findings, of intraosseous hemangioma of long tubular bones and to improve the recognition of this rare tumor. The imaging characteristics of 16 histopathologically diagnosed long tubular bone hemangioma lesions were retrospectively reviewed on radiography (n = 16), CT (n = 16), and MRI (n = 15). Thirteen of 16 lesions were intramedullary, whereas the other three were cortical, subperiosteal, and mixed intracortical and intramedullary, respectively. The radiologic appearance of long bone intraosseous hemangioma was divided into five types: cyst-like (n = 7), mesh- or honeycomb-like (n = 6), medullary sclerosis (n = 1), cortical thickening (n = 1), and cortical lytic type (n = 1). Radiography and CT allowed the identification of sclerotic margins in eight cases, thickened trabeculae in six cases, internal calcification in one case, cortical thickening in one case, and fracture in four cases. Two lesions were confusing on radiography but clearly identifiable on MRI. All intraosseous hemangioma showed high signal intensity on T2-weighted imaging and intermediate signal intensity on T1-weighted imaging. Four cyst-like lesions showed peripheral and filling enhancement, whereas others exhibited diffuse enhancement with an intensity similar to adjacent vessels. Cystic and mesh types are the most common types of hemangioma in long tubular bones. MRI can help to define the location and extent of lesions. The tumor usually shows high signal intensity on T2-weighted imaging and intermediate signal intensity on T1-weighted imaging. Peripheral and filling or diffuse enhancement with an intensity similar to vessels is helpful for the diagnosis of intraosseous hemangioma.

A Case of Intraosseous Hemangioma in the Nasal Cavity

Osseous hemangioma typically occurs in the vertebral column or skull bones. It it is extremely rare in the nasal bone. Only nine cases originating in the turbinate and maxillary bone have been reported in the English and Korean literature. Herein, we present the case of a 51-year-old women with a dorsum mass to share our experience with intraosseous hemangioma successfully removed and reconstructed by an endonasal approach.

Precision in Oculofacial Surgery: Made-To-Specification Cast-Molded Implants in Orbital Reconstruction.

To describe the utilization of customized made-to-specification porous polyethylene implants and to evaluate clinical characteristics and outcomes of patients who received these implants for unilateral orbital defects. A retrospective review of 9 patients was performed. Three-dimensional surface models were generated from high-resolution computed tomography scans. Orbital constructs were modeled after the normal, contralateral orbits and mirrored across the vertical midline to generate the target orbital implant. Measured outcomes included globe position, extraocular motility, facial symmetry, and diplopia. Patients ranged 25-56 years old (mean: 37) and included 6 males and 3 females. Cases consisted of 6 orbital floor fractures due to trauma, 1 lateral wall defect after neurofibroma resection, 1 floor/medial wall defect after myxoma resection, and 1 superior orbital rim defect after intraosseous hemangioma resection. Seven patients had ≥1 prior repair. All patients had previous hard and soft tissue defects and varying degrees of restrictive globe motility. Patients exhibited improved ductions after implant placement and improved facial appearance and symmetry. Post-operatively, 1 patient was found to have a small orbital hematoma between the implant and orbital floor, resolving within weeks. Precision, personalized oculofacial surgery is the next wave in tailoring surgical care to the individual patient. Customizable implants are manufactured to specifically mold to an individual patient's unique bony architecture, which can lead to superior outcomes in reconstructing orbital and craniofacial bony defects. This technique is particularly useful in patients with prior unsuccessful repair.

Intraossäres Hämangiom im Unterkiefer ­- wenn die Wunde nach der Weisheits­ zahnentfernung nicht heilt

Intraosseous hemangiomas in the jaw area are rare pathological changes that occur in the mandible, particularly in the premolar and molar region. Clinically, a slowly increasing painless swelling is typical. Recurrent spontaneous bleeding and paresthesia may also occur. Radiologically, osteolytic zones with a soap bubble-like appearance are usually seen. The current classification of the "International Society for the Study of Vascular Anomalies (ISSVA)" distinguishes hemangiomas from vascular malformations. Hemangiomas are true, benign endothelial tumors, and vascular malformations are hamartoma-like changes that are already present at birth. In the present case, a 36-year-old patient presented to his dentist with increasing numbness of the left lower lip.

Hemangiomas of the oral and maxillofacial region: A series of five cases with literature review

Most of the vascular tumors in the maxillofacial region are hemangiomas. Hemangiomas are basically benign lesions of a vascular origin. This article describes a series of five cases on hemangioma recorded on the lip, buccal mucosa, and zygoma. Here, we present four variants of hemangioma, namely cavernous hemangioma, capillary hemangioma, lobular capillary hemangioma, and intraosseous hemangioma, which were reported to our Maxillofacial Unit.