EURORAD ESR

Case 14995

Epithelioid Hemangioma

Author(s)
Smeet Patel, MD.
Kristin Walker, BS
Alex Calvijo, MD
Yulia Melenevsky, MD.
Eran Rotem, MD, MPH.
Jayanth Keshavamurthy, MD.

1120 15Th street, BA-1411 30912 Augusta, United States of America; Email:jkeshavamurthy@augusta.edu
 
Patient
male, 30 year(s)
 
 
  • Figure 1
    AP Pelvis Radiograph

    Lytic expansile-lesion with shell type periosteal reaction is present within the right superior pubic ramus, extending into the inferior pubic ramus and medial wall of right acetabulum. The superior and inferior...

     
    Area of Interest: Pelvis; Imaging Technique: Conventional radiography; Procedure: History; Special Focus: Haemangioma;
     
     
  • Figure 2
    MR Cor T1WI Post Gad

    4.5x3.5x4.0 cm Multi-loculated avidly enhancing lesion is present in the right anterior acetabulum and right superior pubic ramus, with associated expansion of the osseous structures.

     
    Area of Interest: Pelvis; Imaging Technique: MR; Procedure: Localisation; Special Focus: Haemangioma;
     
     
  • Figure 3
    CT guided percutaneous biopsy

    CT-guided biopsy of right acetabular bone lesion. Samples were sent to pathology in formalin.

     
    Area of Interest: Pelvis; Imaging Technique: CT; Procedure: Biopsy; Special Focus: Haemangioma;
     
     
  • Figure 4
    Angiogram right extremity pre-embolization

    Referred to IR prior to surgical intervention. Arterial catheterization of arteries in the right lower extremity.

     
    Area of Interest: Pelvis; Imaging Technique: Catheter arteriography; Procedure: Contrast agent-oral; Special Focus: Haemangioma;
     
     
  • Figure 5
    Post Gel-foam embolization angiogram

    successful embolizations of the right inferior gluteal, obturator and inferior branches of the superior gluteal arteries

     
    Area of Interest: Pelvis; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Haemangioma;
     
     
  • Figure 6
    Pathology
     

    +CD31 and SMA immunohistochemistry stains. Diffuse pericystic layer around well differentiated vessels. Areas of characteristic cellular region which is surrounded by a collar of loose connective tissue that contains...

     
    Area of Interest: Pelvis; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Haemangioma;

    The cellular component consists of cords and sheets of proliferating epithelioid endothelial cells .

     
    Area of Interest: Pelvis; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Haemangioma;

    Well-formed vessels are numerous, tumor cells bulge into lumen in tombstone or hobnail-like fashion

     
    Area of Interest: Pelvis; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Haemangioma;
     
     
Lytic expansile-lesion with shell type periosteal reaction is present within the right superior pubic ramus, extending into the inferior pubic ramus and medial wall of right acetabulum. The superior and inferior borders are indistinct.
 
4.5x3.5x4.0 cm Multi-loculated avidly enhancing lesion is present in the right anterior acetabulum and right superior pubic ramus, with associated expansion of the osseous structures.
 
CT-guided biopsy of right acetabular bone lesion. Samples were sent to pathology in formalin.
 
Referred to IR prior to surgical intervention. Arterial catheterization of arteries in the right lower extremity.
 
successful embolizations of the right inferior gluteal, obturator and inferior branches of the superior gluteal arteries
 
+CD31 and SMA immunohistochemistry stains. Diffuse pericystic layer around well differentiated vessels. Areas of characteristic cellular region which is surrounded by a collar of loose connective tissue that contains many arteriolar-like structures (inset) *yellow arrows.
 
The cellular component consists of cords and sheets of proliferating epithelioid endothelial cells .
 
Well-formed vessels are numerous, tumor cells bulge into lumen in tombstone or hobnail-like fashion
 
 
 
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