First Department of Orthopedics, National and Kapodistrian University of Athens, Medical School, ATTIKON University General Hospital, GREECE.
First Department of Pathology, National and Kapodistrian University of Athens, LAIKON General Hospital, Athens, Greece.
J Long Term Eff Med Implants. 2022;32(4):47-55. doi: 10.1615/JLongTermEffMedImplants.2022041868.
Epithelioid hemangioma (EH) of bone is a rare benign, albeit locally aggressive vascular neoplasm. It is usually solitary and involves the metaphysis or diaphysis of long tubular bones, especially in the lower extremities. Rarely it may present as multifocal lesions. The differential diagnosis includes malignant vascular bone tumors such as epithelioid hemangioendothelioma and epithelioid angiosarcoma. Clinical presentation and radiographic and histological findings are not specific and diagnosis is based mostly on immunohistochemical and molecular studies. There is no consensus regarding the optimal treatment. Curettage and bone grafting or en bloc resection are the current treatment options, however local recurrence have been reported. We present a case of multifocal EH of the distal tibia, distal fibula and hindfoot in a 38 year-old male managed with curettage, radiofrequency ablation and cement osteoplasty. The imaging features, histological findings and treatment options of this rare vascular tumor are discussed.
骨上皮样血管内皮瘤（EH）是一种罕见的良性但局部侵袭性的血管肿瘤。它通常为单发，累及长管状骨的干骺端或骨干，尤其是下肢。罕见情况下，它可能表现为多灶性病变。鉴别诊断包括恶性血管骨肿瘤，如上皮样血管内皮瘤和上皮样血管肉瘤。临床表现、影像学和组织学表现均不具有特异性，诊断主要基于免疫组化和分子研究。对于最佳治疗方法尚无共识。刮除和植骨或整块切除术是目前的治疗选择，但已报道有局部复发的情况。我们报告了 1 例 38 岁男性的胫骨远端、腓骨远端和后足多灶性 EH 病例，采用刮除、射频消融和骨水泥骨成形术治疗。讨论了这种罕见的血管肿瘤的影像学特征、组织学发现和治疗选择。
