Multiple Intraosseous Hemangiomas: Uncommon Location.

A 74-year-old woman presented with a history of right leg pain. She did not have any obvious past or recent history of physical trauma. Knee radiography showed an oval hypertranslucent lesion in the right tibia (Picture 1). Computed tomography revealed an osteolytic tumor in the left ilium and the right tibia (Picture 2). The left iliac lesion appeared hyperintense on T2-weighted short-tau inversion recovery magnetic resonance imaging (Picture 3a) and showed gradual enhancement from the periphery with gadolinium (Picture 3b-d). A biopsy specimen from the tibial lesion showed capillary hyperplasia and endothelial cell proliferation, indicating intraosseous capillary hemangioma (Picture 4).

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Picture 2.

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Intraosseous hemangiomas account for ＜1.0% of all bone tumors and commonly involve the spine. The involvement of long and flat bones is uncommon (1). These hemangiomas appear as hyperintense regions on T2-weighted magnetic resonance imaging and were enhanced with gadolinium (2). Intraosseous hemangioma should be considered when a patient presents with multiple osteolytic lesions. Magnetic resonance imaging aids in the differential diagnosis of these hemangiomas.

The authors state that they have no Conflict of Interest (COI).