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Hemangioma: Intraosseous
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Capillary hemangioma, cavernous hemangioma, venous hemangioma, angioma, histiocytoid hemangioma, angiomatosis, cystic angiomatosis, skeletal hemangiomatosis, cystic lymphangiectasia, hemolymphangiomatosis
          • Gorham disease: Disappearing bone disease, phantom bone disease, massive osteolysis
        • Definitions

          • Hemangioma: Benign lesion composed of blood vessels
            • Capillary hemangioma: Usually in vertebral body
            • Cavernous hemangioma: Usually in flat bone (calvaria, ilium)
            • Venous and arteriovenous hemangiomas involve bone in extremely rare cases; usually soft tissue
          • Lymphangioma: Sequestered, noncommunicating lymphoid tissue lined by lymphatic endothelium
          • Angiomatosis: Diffuse infiltration of bone or soft tissue by hemangiomatous or lymphangiomatous lesions
            • Cystic angiomatosis: Extensive involvement of bone by angiomatosis
          • Massive osteolysis (Gorham or disappearing bone disease) considered to be within spectrum of benign vascular lesions

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Nuclear Medicine Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Matsumoto Y et al: Intraosseous hemangioma arising in the clavicle. Skeletal Radiol. 43(1):89-93, 2014
                                  2. Rigopoulou A et al: Intraosseous hemangioma of the appendicular skeleton: imaging features of 15 cases, and a review of the literature. Skeletal Radiol. 41(12):1525-36, 2012
                                  3. Barzin M et al: Incidence of vertebral hemangioma on spinal magnetic resonance imaging in Northern Iran. Pak J Biol Sci. 12(6):542-4, 2009
                                  4. Guarnieri G et al: Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up. Neuroradiology. 51(7):471-6, 2009
                                  5. Nielsen GP et al: Epithelioid hemangioma of bone revisited: a study of 50 cases. Am J Surg Pathol. 33(2):270-7, 2009
                                  6. Sasagawa Y et al: Multiple cavernous hemangiomas of the skull associated with hepatic lesions. Case report. Neurol Med Chir (Tokyo). 49(4):162-6, 2009
                                  7. Acosta FL Jr et al: Comprehensive management of symptomatic and aggressive vertebral hemangiomas. Neurosurg Clin N Am. 19(1):17-29, 2008
                                  8. Aksu G et al: Spinal cord compression due to vertebral hemangioma. Orthopedics. 31(2):169, 2008
                                  9. Di Giorgio L et al: Surface-based haemangioma of the tibia: a case report. Chir Organi Mov. 92(3):169-73, 2008
                                  10. Escande C et al: Histological features and management of a mandibular Gorham disease: a case report and review of maxillofacial cases in the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 106(3):e30-7, 2008
                                  11. Malik R et al: Skeletal angiomatosis - rare cause of bone destruction: a case report with review of literature. Indian J Pathol Microbiol. 51(4):515-8, 2008
                                  12. Chawla A et al: Intraosseous haemangioma of the proximal femur: imaging findings. Br J Radiol. 79(944):e64-6, 2006
                                  13. van der Linden-van der Zwaag H et al: Massive osteolysis (Gorham's disease) affecting the femur. Acta Orthop Belg. 72(3):261-8, 2006
                                  14. Lo CP et al: Disappearing calvarium in Gorham disease: MR imaging characteristics with pathologic correlation. AJNR Am J Neuroradiol. 25(3):415-8, 2004
                                  15. Vilanova JC et al: Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics. 24(2):367-85, 2004
                                  16. Vanhoenacker FM et al: Cystic angiomatosis with splenic involvement: unusual MRI findings. Eur Radiol. 13 Suppl 6:L35-9, 2003
                                  17. Adler CP et al: hemangioma and related lesions. In Fletcher CDM et al: World Health Organization classification of Tumours: Tumours of Soft Tissue and Bone. Lyon: IARC Press, 2002
                                  18. Greenspan A et al: Differential diagnosis of tumors and tumor-like lesions of bones and joints. Philadelphia: Lippincott-Raven, 1998
                                  19. Lomasney LM et al: Multifocal vascular lesions of bone: imaging characteristics. Skeletal Radiol. 25(3):255-61, 1996
                                  20. Murphey MD et al: From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 15(4):893-917, 1995
                                  21. Ross JS et al: Vertebral hemangiomas: MR imaging. Radiology. 165(1):165-9, 1987
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Synonyms

                                          • Capillary hemangioma, cavernous hemangioma, venous hemangioma, angioma, histiocytoid hemangioma, angiomatosis, cystic angiomatosis, skeletal hemangiomatosis, cystic lymphangiectasia, hemolymphangiomatosis
                                          • Gorham disease: Disappearing bone disease, phantom bone disease, massive osteolysis
                                        • Definitions

                                          • Hemangioma: Benign lesion composed of blood vessels
                                            • Capillary hemangioma: Usually in vertebral body
                                            • Cavernous hemangioma: Usually in flat bone (calvaria, ilium)
                                            • Venous and arteriovenous hemangiomas involve bone in extremely rare cases; usually soft tissue
                                          • Lymphangioma: Sequestered, noncommunicating lymphoid tissue lined by lymphatic endothelium
                                          • Angiomatosis: Diffuse infiltration of bone or soft tissue by hemangiomatous or lymphangiomatous lesions
                                            • Cystic angiomatosis: Extensive involvement of bone by angiomatosis
                                          • Massive osteolysis (Gorham or disappearing bone disease) considered to be within spectrum of benign vascular lesions

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • CT Findings

                                              • MR Findings

                                                • Nuclear Medicine Findings

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Gross Pathologic & Surgical Features

                                                        • Microscopic Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Matsumoto Y et al: Intraosseous hemangioma arising in the clavicle. Skeletal Radiol. 43(1):89-93, 2014
                                                                  2. Rigopoulou A et al: Intraosseous hemangioma of the appendicular skeleton: imaging features of 15 cases, and a review of the literature. Skeletal Radiol. 41(12):1525-36, 2012
                                                                  3. Barzin M et al: Incidence of vertebral hemangioma on spinal magnetic resonance imaging in Northern Iran. Pak J Biol Sci. 12(6):542-4, 2009
                                                                  4. Guarnieri G et al: Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up. Neuroradiology. 51(7):471-6, 2009
                                                                  5. Nielsen GP et al: Epithelioid hemangioma of bone revisited: a study of 50 cases. Am J Surg Pathol. 33(2):270-7, 2009
                                                                  6. Sasagawa Y et al: Multiple cavernous hemangiomas of the skull associated with hepatic lesions. Case report. Neurol Med Chir (Tokyo). 49(4):162-6, 2009
                                                                  7. Acosta FL Jr et al: Comprehensive management of symptomatic and aggressive vertebral hemangiomas. Neurosurg Clin N Am. 19(1):17-29, 2008
                                                                  8. Aksu G et al: Spinal cord compression due to vertebral hemangioma. Orthopedics. 31(2):169, 2008
                                                                  9. Di Giorgio L et al: Surface-based haemangioma of the tibia: a case report. Chir Organi Mov. 92(3):169-73, 2008
                                                                  10. Escande C et al: Histological features and management of a mandibular Gorham disease: a case report and review of maxillofacial cases in the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 106(3):e30-7, 2008
                                                                  11. Malik R et al: Skeletal angiomatosis - rare cause of bone destruction: a case report with review of literature. Indian J Pathol Microbiol. 51(4):515-8, 2008
                                                                  12. Chawla A et al: Intraosseous haemangioma of the proximal femur: imaging findings. Br J Radiol. 79(944):e64-6, 2006
                                                                  13. van der Linden-van der Zwaag H et al: Massive osteolysis (Gorham's disease) affecting the femur. Acta Orthop Belg. 72(3):261-8, 2006
                                                                  14. Lo CP et al: Disappearing calvarium in Gorham disease: MR imaging characteristics with pathologic correlation. AJNR Am J Neuroradiol. 25(3):415-8, 2004
                                                                  15. Vilanova JC et al: Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics. 24(2):367-85, 2004
                                                                  16. Vanhoenacker FM et al: Cystic angiomatosis with splenic involvement: unusual MRI findings. Eur Radiol. 13 Suppl 6:L35-9, 2003
                                                                  17. Adler CP et al: hemangioma and related lesions. In Fletcher CDM et al: World Health Organization classification of Tumours: Tumours of Soft Tissue and Bone. Lyon: IARC Press, 2002
                                                                  18. Greenspan A et al: Differential diagnosis of tumors and tumor-like lesions of bones and joints. Philadelphia: Lippincott-Raven, 1998
                                                                  19. Lomasney LM et al: Multifocal vascular lesions of bone: imaging characteristics. Skeletal Radiol. 25(3):255-61, 1996
                                                                  20. Murphey MD et al: From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics. 15(4):893-917, 1995
                                                                  21. Ross JS et al: Vertebral hemangiomas: MR imaging. Radiology. 165(1):165-9, 1987