Haemangioma

Definition

 

Benign, malformed vascular lesions

 

Intraosseous Hemangioma

 

Epidemiology

 

Vertebral column

Skull

Long bones rare

 

Clinical

 

Usually asymptomatic

 

Xray

 

Characteristic finding is prominent trabecula pattern

 

HIp hemangiomaHip hemangioma

 

Spine 

- characteristic honeycomb appearance

- "jail bar"

 

CT

 

Characteristic finding is "polka dots"

 

CT hemangioma spine

 

MRI 

 

Usually bright on T1 & T2 images because of fat content

 

Hemangioma Spinehemangioma MR hemangioma MR

 

Management

 

Asymptomatic

Typically nonoperative

 

Soft tissue Hemangioma

 

Associations

 

1.  Klippel Trenaunay Weber Syndrome 

- hemihypertrophy with underlying venous malformations

- secondary to increased angiogenesis

- upper limb, lower limb or both affected

- usually unilateral

 

2.  Maffucci Syndrome

 

3.  Sturge-Weber

- rare congenital / not hereditary

- often facial capillary malformation

- more extensive hemangiomata

- development delay / seizures / hemiparesis  

- hemiatrophy

 

Clinical

 

Ache

Limb heaviness

Lesions in the skin - distended bluish discolouration 

Deeper intramuscular lesions present as a tender mass

 

X-ray

 

Often small calcified nodules / phleboliths

- circular pattern with a radiolucent center (due to recanalization) 

- same as those seen in the pelvic veins of multiparous females

 

CT

 

Polka dot appearance due to section through the vessels

 

These lesions often penetrate the bone and have a large soft tissue component

 

MRI

 

Exceedingly bright signal due to the high fluid content of the lesion 

 

Hemangioma Soft Tissue

 

Management

 

Non-operative

- stockings

- simple analgesia

 

Operative

- embolization

- resection

 

Hemangioma Embolisation