Recurrence of Cortical Venous Haemangioma in the Tibia: Interest of Sclerotherapy
Author(s)
Mohamed Bouabdellah1,
Madiha Mahfoudhi2*,
Imen Gorsane2,
Hatem Rajhi3,
Wael Chabbi1,
Ramzi Bouzidi1
Affiliation(s)
1 Orthopedy Department, Charles Nicolle Hospital, Tunis, Tunisia. 2 Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia. 3 Radiology Department, Charles Nicolle Hospital, Tunis, Tunisia.
1 Orthopedy Department, Charles Nicolle Hospital, Tunis, Tunisia. 2 Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia. 3 Radiology Department, Charles Nicolle Hospital, Tunis, Tunisia.
ABSTRACT
We report on a rare case of an intra-osseous haemangioma involving the medial portion of tibia in a 29-year-old man. The aim is to emphasize on diagnosis difficulties, possible recurrence and interest of sclerotherapy. In radiographs, the lesion was a well-defined osteolytic lesion having 3 mm of diameter with perimeter’s sclerosis. The computed tomography images demonstrated an intra-medullar gap’s image of the tibia with cortical participation. An osteoid osteoma was evocated but eliminated by the histhological examination. The osseous scintigraphy didn’t find any anomaly. The outcome was marked by the recurrence of pain. T1-weighted Magnetic resonance imaging showed a hypointense lesion, while T2-weighted images revealed hyperintense areas, with internal, hypointense septa. Gadolinium-enhanced T1-weighted images showed lattice-like enhancement of the lesion. These images signed a recurrence of the intra-osseous venous haemangioma. The sclerotherapy improved the pain in three days and prevented another recurrence.
We report on a rare case of an intra-osseous haemangioma involving the medial portion of tibia in a 29-year-old man. The aim is to emphasize on diagnosis difficulties, possible recurrence and interest of sclerotherapy. In radiographs, the lesion was a well-defined osteolytic lesion having 3 mm of diameter with perimeter’s sclerosis. The computed tomography images demonstrated an intra-medullar gap’s image of the tibia with cortical participation. An osteoid osteoma was evocated but eliminated by the histhological examination. The osseous scintigraphy didn’t find any anomaly. The outcome was marked by the recurrence of pain. T1-weighted Magnetic resonance imaging showed a hypointense lesion, while T2-weighted images revealed hyperintense areas, with internal, hypointense septa. Gadolinium-enhanced T1-weighted images showed lattice-like enhancement of the lesion. These images signed a recurrence of the intra-osseous venous haemangioma. The sclerotherapy improved the pain in three days and prevented another recurrence.
KEYWORDS
Intra-Osseous Haemangioma, Computed Tomography, Magnetic Resonance Imaging, Tibia, Sclerotherapy
Intra-Osseous Haemangioma, Computed Tomography, Magnetic Resonance Imaging, Tibia, Sclerotherapy
Cite this paper
Bouabdellah, M. , Mahfoudhi, M. , Gorsane, I. , Rajhi, H. , Chabbi, W. and Bouzidi, R. (2015) Recurrence of Cortical Venous Haemangioma in the Tibia: Interest of Sclerotherapy. International Journal of Clinical Medicine, 6, 661-666. doi: 10.4236/ijcm.2015.69088.
Bouabdellah, M. , Mahfoudhi, M. , Gorsane, I. , Rajhi, H. , Chabbi, W. and Bouzidi, R. (2015) Recurrence of Cortical Venous Haemangioma in the Tibia: Interest of Sclerotherapy. International Journal of Clinical Medicine, 6, 661-666. doi: 10.4236/ijcm.2015.69088.
References
[1] Kenan, S., Abdelwahab, I.F., Klein, M.J. and Lewis, M.M. (1992) Hemangiomas of the Long Tubular Bone. Clinical Orthopaedics and Related Research, No. 280, 256-260.
http://dx.doi.org/10.1097/00003086-199207000-00035 [2] Ogose, A., Hotta, T., Morita, T., Takizawa, T., Ohsawa, H. and Harita, Y. (2000) Solitary Osseous Hemangioma outside the Spinal and the Craniofacial Bones. Archives of Orthopaedic and Trauma Surgery, 120, 262-266.
http://dx.doi.org/10.1007/s004020050461 [3] Sherman, R.S. and Wilner, D. (1961) The Roentgen Diagnosis of Hemangioma of Bone. The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 86, 1146-1159. [4] Resnik, D., Kyriakos, M. and Greenway, G.D. (2002) Tumours and Tumour-Like Lesions of Bone. In: Resnik, D, Ed., Diagnosis of Bone and Joint Disorders, 4th Edition, Saunders, Philadelphia, 3979-3985. [5] Yamamoto, T., Kurosaka, M. and Mizuno, K. (2000) Juxta-Articular Hemangioma of Long Bone. Skeletal Radiology, 29, 535-537.
http://dx.doi.org/10.1007/s002560000256 [6] Thomas, A.M.C., Mulligan, P.J. and Jones, E.L. (1990) Benign Haemangioma of Bone in a Middle Phalanx. The Journal of Hand Surgery, 15, 484-486.
http://dx.doi.org/10.1016/0266-7681(90)90097-N [7] Wenger, D.E. and Wold, L.E. (2000) Benign Vascular Lesions of Bone: Radiologic and Pathologic Features. Skeletal Radiology, 29, 63-74.
http://dx.doi.org/10.1007/s002560050012 [8] Kaleem, Z., Kyriakos, M. and Totty, W.G. (2000) Solitary Skeletal Hemangioma of the Extremities. Skeletal Radiology, 29, 502-513.
http://dx.doi.org/10.1007/s002560000251 [9] Levine, S.M., Lambiase, R.E. and Petchprapa, C.N. (2003) Cortical Lesions of the Tibia: Characteristic Appearances at Conventional Radiography. RadioGraphics, 23, 157-177.
http://dx.doi.org/10.1148/rg.231015088 [10] Yu, L., Cai, L., Yu, G.R., Zeng, Z.H. and Tao, S.X. (2009) Solitary Giant Hemangioma of the Humerus. Orthopedics, 32, 925.
http://dx.doi.org/10.3928/01477447-20091020-24 [11] Chawla, A., Singrakhia, M., Maheshwari, M., Modi, N. and Parmar, H. (2006) Intraosseous Haemangioma of the Proximal Femur: Imaging Findings. British Journal of Radiology, 79, 64-66.
http://dx.doi.org/10.1259/bjr/53131368 [12] Weiner, D. and Leeson, M.C. (1990) Hemangioma of the Tibia. Orthopedics, 13, 1397-1400. [13] Matsuyama, A., Aoki, T., Hisaoka, M., Yokoyama, K. and Hashimoto, H. (2008) A Case of Intraosseous Arteriovenous Malformation with Unusual Radiological Presentation of Low Blood Flow. Pathology—Research and Practice, 204, 423-426.
http://dx.doi.org/10.1016/j.prp.2008.01.006 [14] Cristofaro, R D., Biagini, R., Boriani, S., Ricci, S., Ruggieri, P. and Rossi, G. (1992) Selective Arterial Embolization in the Treatment of Aneurysmal Bone Cyst and Angioma of Bone. Skeletal Radiology, 21, 523-527.
http://dx.doi.org/10.1007/BF00195235 [15] Bas, T., Aparisi, F. and Bas, J.L. (2001) Efficacy and Safety of Ethanol Injections in 18 Cases of Vertebral Hemangioma. Spine, 26, 1577-1582.
http://dx.doi.org/10.1097/00007632-200107150-00015 [16] Cohen, J.E., Lylyk, P., Ceratto, R., Kaplan, L., Umansky, F. and Gomori, J.M. (2004) Percutaneous Vertebroplasty: Technique and Results in 192 Procedures. Neurological Research, 26, 41-49.
http://dx.doi.org/10.1179/016164104773026516
[1] Kenan, S., Abdelwahab, I.F., Klein, M.J. and Lewis, M.M. (1992) Hemangiomas of the Long Tubular Bone. Clinical Orthopaedics and Related Research, No. 280, 256-260.
http://dx.doi.org/10.1097/00003086-199207000-00035 [2] Ogose, A., Hotta, T., Morita, T., Takizawa, T., Ohsawa, H. and Harita, Y. (2000) Solitary Osseous Hemangioma outside the Spinal and the Craniofacial Bones. Archives of Orthopaedic and Trauma Surgery, 120, 262-266.
http://dx.doi.org/10.1007/s004020050461 [3] Sherman, R.S. and Wilner, D. (1961) The Roentgen Diagnosis of Hemangioma of Bone. The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 86, 1146-1159. [4] Resnik, D., Kyriakos, M. and Greenway, G.D. (2002) Tumours and Tumour-Like Lesions of Bone. In: Resnik, D, Ed., Diagnosis of Bone and Joint Disorders, 4th Edition, Saunders, Philadelphia, 3979-3985. [5] Yamamoto, T., Kurosaka, M. and Mizuno, K. (2000) Juxta-Articular Hemangioma of Long Bone. Skeletal Radiology, 29, 535-537.
http://dx.doi.org/10.1007/s002560000256 [6] Thomas, A.M.C., Mulligan, P.J. and Jones, E.L. (1990) Benign Haemangioma of Bone in a Middle Phalanx. The Journal of Hand Surgery, 15, 484-486.
http://dx.doi.org/10.1016/0266-7681(90)90097-N [7] Wenger, D.E. and Wold, L.E. (2000) Benign Vascular Lesions of Bone: Radiologic and Pathologic Features. Skeletal Radiology, 29, 63-74.
http://dx.doi.org/10.1007/s002560050012 [8] Kaleem, Z., Kyriakos, M. and Totty, W.G. (2000) Solitary Skeletal Hemangioma of the Extremities. Skeletal Radiology, 29, 502-513.
http://dx.doi.org/10.1007/s002560000251 [9] Levine, S.M., Lambiase, R.E. and Petchprapa, C.N. (2003) Cortical Lesions of the Tibia: Characteristic Appearances at Conventional Radiography. RadioGraphics, 23, 157-177.
http://dx.doi.org/10.1148/rg.231015088 [10] Yu, L., Cai, L., Yu, G.R., Zeng, Z.H. and Tao, S.X. (2009) Solitary Giant Hemangioma of the Humerus. Orthopedics, 32, 925.
http://dx.doi.org/10.3928/01477447-20091020-24 [11] Chawla, A., Singrakhia, M., Maheshwari, M., Modi, N. and Parmar, H. (2006) Intraosseous Haemangioma of the Proximal Femur: Imaging Findings. British Journal of Radiology, 79, 64-66.
http://dx.doi.org/10.1259/bjr/53131368 [12] Weiner, D. and Leeson, M.C. (1990) Hemangioma of the Tibia. Orthopedics, 13, 1397-1400. [13] Matsuyama, A., Aoki, T., Hisaoka, M., Yokoyama, K. and Hashimoto, H. (2008) A Case of Intraosseous Arteriovenous Malformation with Unusual Radiological Presentation of Low Blood Flow. Pathology—Research and Practice, 204, 423-426.
http://dx.doi.org/10.1016/j.prp.2008.01.006 [14] Cristofaro, R D., Biagini, R., Boriani, S., Ricci, S., Ruggieri, P. and Rossi, G. (1992) Selective Arterial Embolization in the Treatment of Aneurysmal Bone Cyst and Angioma of Bone. Skeletal Radiology, 21, 523-527.
http://dx.doi.org/10.1007/BF00195235 [15] Bas, T., Aparisi, F. and Bas, J.L. (2001) Efficacy and Safety of Ethanol Injections in 18 Cases of Vertebral Hemangioma. Spine, 26, 1577-1582.
http://dx.doi.org/10.1097/00007632-200107150-00015 [16] Cohen, J.E., Lylyk, P., Ceratto, R., Kaplan, L., Umansky, F. and Gomori, J.M. (2004) Percutaneous Vertebroplasty: Technique and Results in 192 Procedures. Neurological Research, 26, 41-49.
http://dx.doi.org/10.1179/016164104773026516