Multidisciplinary, articular surface-preserving treatment strategy for locally aggressive epithelioid hemangioma of the acetabulum employing serial bland transarterial embolization

Skeletal Radiol. 2022 Jul;51(7):1493-1498. doi: 10.1007/s00256-021-03977-4. Epub 2022 Jan 10.

Abstract

Epithelioid hemangioma is a rare, histologically benign but locally aggressive primary vascular neoplasm that can rarely arise in bone. Mainstay treatment is surgical resection or curettage with bone grafting. We report a novel multidisciplinary, joint-sparing treatment approach for an epithelioid hemangioma of bone arising in the acetabulum causing severe thinning of the subchondral bone plate. After 4 sessions of transarterial bland particle and ethanol embolization, the resultant increased ossification of the tumor allowed preservation of the articular surface during surgical resection. Imaging follow-up 14 months after surgical resection showed no evidence of recurrence and continued ossification of the portions of the lesion treated only with embolization.

Keywords: Epithelioid hemangioma; Vascular anomalies.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / pathology
  • Acetabulum / surgery
  • Bone Neoplasms* / diagnostic imaging
  • Bone Neoplasms* / pathology
  • Bone Neoplasms* / therapy
  • Bone Transplantation
  • Curettage / methods
  • Hemangioma* / diagnostic imaging
  • Hemangioma* / therapy
  • Humans
  • Vascular Neoplasms* / pathology