Which of the following is/are TRUE about hemangioma of bone? 1. Mostly asymptomatic 2. Peak incidence in 5th decade 3. Constitute 10-20% of total bone tumor 4. Overgrowth of bone occurs 5. Hematogenous spread
Correct Answer: 1,2,4,5 true & 3 false
Description: Bone hemangiomas are benign, malformed vascular lesion, overall constituting less than 1% of all primary bone neoplasm. They occur most frequently in the veebral column (30-50%) and skull (20%), whereas involvement of other sites (including the long bones, sho tubular bones, and ribs) is extremely rare. Peak incidence occur in the 50s. Hemangiomas are largely asymptomatic, and thus most are never discovered, leading some to describe these lesions as "rare". Veebral hemangiomas can cause neurological symptoms if they extend into the epidural space. Appearance on X-ray is depend on the location. The lesions are often poorly defined,appearing as a somewhat localized area of abundant, dilated vessels, some of which may on the surface of the bone, within the coex of the bone, or extend into the medullary cavity. However, the radiographic hallmark of bone hemangiomas is a prominent trabecular pattern. Despite the added diagnostic information available with CT scanning and MRI, the angiomatous nature of many extraspinal lesions can be confirmed only by histologic analysis. On gross examination, hemangiomas look like a disorganised collection of veins or vascular spaces. Grossly there are cystic, dark red cavities. The lytic areas are sharply defined and there is trabecular thickening. Under the microscope, there are four type of hemangiomas : capillary, cavernous, aeriovenous, and venous. Capillary and cavernous lesions are most common in bone. Treatment of hemangiomas is unnecessary unless the lesion is symptomatic. Hemangiomas: Most bonafide hemangiomas in bone are solitary lesions. Comprises less than 1.5 % of the total series. Female preponderance in a ratio of 3 : 2. Hemangiomas are usually found in adults. Many of the hemangiomas are asymptomatic. Hemangiomas that expands the bone and produce new bone may cause notable swelling. Local pain is sometimes a feature. There may be fracture, including compression fracture of veebra, Rarely, spinal cord compression may occur. Hemangiomas in veebrae characteristically cause polka-dot appearance on computed tomograms. Hemangiomas usually respond well to conservative procedures. Radiation may be required for lesions that ar in inaccessible sites. Massive hemangiomas, especially with involvement of soft tissues, may require amputation. Ref: Apley's 8/e, p 183; Dahne Radiology manual 5/e, p 98 ; Bone and Soft tissue tumour by Ajay Puri 1st/203-04 ; Atlas of Ohopedic Pathology 2/e, p 335-38 ; emedicine.medscape.com>......> radiology> musculoskeletal.
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