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Hemangiomas are benign bone lesions characterized by vascular spaces lined with endothelial cells. Approximately 50% of osseous hemangiomas are found in the vertebral bodies (thoracic especially) and 20% are located in the calvarium. The remaining lesions are found in the tibia, femur and humerus.
Vertebral hemangiomas can cause neurological symptoms if they extend into the epidural space. Symptoms may vary with other factors that cause vascular distension or reactivity, such as dependency, activity, pregnancy and menstruation.
Treatment of hemangioma is unnecessary unless the lesion is symptomatic. Minor discomfort may be treated with compression of he lesion using vascular stockings, ace wraps, or compression tights or shorts. Surgeons should avoid treatment of minorly symptomatic lesions. Painful intraosseous lesions without cord compression may be treated with balloon kyphoplasty, vertebroplasty or transarterial embolization. In the spine, hemangiomas may compress the cord without causing instability or deformity, and these are best treated with conservative surgical removal. More aggressive lesions are treated with embolization followed by complete intralesional spondylectomy. Lesions in the calvarium should be resected with a thin margin of normal bone. Painful long bone lesions may also be treated with direct sclerotherapy, intralesional excision or or transarterial embolization. Large lesions in long bones should be excised and packed with bone graft if appropriate. There have been sporadic reports of serious bleeding from these lesions during surgery, and caution is advised with large or deeply placed lesions.
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Hello Anonymous,
Welcome to EmpowHER. Thank you for reaching out to our community.
Hemangiomas are benign bone lesions characterized by vascular spaces lined with endothelial cells. Approximately 50% of osseous hemangiomas are found in the vertebral bodies (thoracic especially) and 20% are located in the calvarium. The remaining lesions are found in the tibia, femur and humerus.
Vertebral hemangiomas can cause neurological symptoms if they extend into the epidural space. Symptoms may vary with other factors that cause vascular distension or reactivity, such as dependency, activity, pregnancy and menstruation.
Treatment of hemangioma is unnecessary unless the lesion is symptomatic. Minor discomfort may be treated with compression of he lesion using vascular stockings, ace wraps, or compression tights or shorts. Surgeons should avoid treatment of minorly symptomatic lesions. Painful intraosseous lesions without cord compression may be treated with balloon kyphoplasty, vertebroplasty or transarterial embolization. In the spine, hemangiomas may compress the cord without causing instability or deformity, and these are best treated with conservative surgical removal. More aggressive lesions are treated with embolization followed by complete intralesional spondylectomy. Lesions in the calvarium should be resected with a thin margin of normal bone. Painful long bone lesions may also be treated with direct sclerotherapy, intralesional excision or or transarterial embolization. Large lesions in long bones should be excised and packed with bone graft if appropriate. There have been sporadic reports of serious bleeding from these lesions during surgery, and caution is advised with large or deeply placed lesions.
Hope this is helpful,
June 1, 2017 - 9:31amMaryann
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