Kumar Jayant, Magloire Jonathan, Quintero Luis, Vakil Deep, Bhatt Himani, Kassira Noor, Levene Tamar, Neville Holly
Department of General Surgery, Memorial Healthcare System, Pembroke Pines, FL 33028, USA.
Department of Surgery and Cancer, Hammersmith Hospital, Imperial College London, London W12 0TS, UK.
J Clin Med. 2024 Sep 20;13(18):5586. doi: 10.3390/jcm13185586.
Bone hemangiomas are rare benign vascular tumors, comprising less than 1% of all bone tumors. They are predominantly found in the vertebral body or skull; rib hemangiomas are particularly rare and are often misdiagnosed as malignant tumors. Given the high malignancy rate of primary rib tumors, understanding rib hemangiomas is crucial to avoid misdiagnosis. A systematic review was conducted according to PRISMA standards. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and Scopus. Data on patient demographics, tumor characteristics, and clinical presentation were analyzed using STATA/SE 17. From 306 articles, 40 studies including 43 patients met the inclusion criteria. Rib hemangiomas showed a bimodal age distribution, with peaks in patients younger than 30 years (mean age 21.43 ± 5.60 years) and ≥30 years (mean age 59.96 ± 9.70 years). Females were more affected (62.79%) than males (37.21%), with a ratio of 1.69:1. The tumors were most frequently located in mid-thoracic ribs (4-8) and predominantly on the left side of the thorax. The mean tumor size was 7.27 cm, with 76.19% exhibiting osteolytic changes. Clinically, 63.41% of cases were asymptomatic, while symptomatic cases mainly presented with pain. Rib hemangiomas, though rare, should be considered in the differential diagnosis of thoracic tumors. They present as well-demarcated lytic lesions with distinct imaging features, and they typically require complete surgical excision, which may be aided with preoperative embolization. Their accurate diagnosis involves a combination of radiologic and clinical evaluation. Further studies are needed to understand the disease's pathophysiology and to refine diagnostic and treatment protocols.
骨血管瘤是罕见的良性血管肿瘤，占所有骨肿瘤的比例不到1%。它们主要见于椎体或颅骨；肋骨血管瘤尤为罕见，常被误诊为恶性肿瘤。鉴于原发性肋骨肿瘤的高恶性率，了解肋骨血管瘤对于避免误诊至关重要。根据PRISMA标准进行了一项系统评价。在PubMed、EMBASE、Web of Science和Scopus中进行了全面的文献检索。使用STATA/SE 17分析了患者人口统计学、肿瘤特征和临床表现的数据。从306篇文章中，40项研究（包括43例患者）符合纳入标准。肋骨血管瘤显示出双峰年龄分布，在30岁以下患者（平均年龄21.43±5.60岁）和≥30岁患者（平均年龄59.96±9.70岁）中出现高峰。女性比男性更易受累（62.79%对37.21%），比例为1.69:1。肿瘤最常位于胸中段肋骨（4-8肋），且主要位于胸部左侧。肿瘤平均大小为7.27 cm，76.19%表现为溶骨性改变。临床上，63.41%的病例无症状，而有症状的病例主要表现为疼痛。肋骨血管瘤虽然罕见，但在胸部肿瘤的鉴别诊断中应予以考虑。它们表现为边界清晰的溶骨性病变，具有独特的影像学特征，通常需要完整的手术切除，术前栓塞可能有助于手术。其准确诊断需要放射学和临床评估相结合。需要进一步研究以了解该疾病的病理生理学，并完善诊断和治疗方案。
