Hemangioma - Pathology - Orthobullets

summary
- Hemangiomas are benign vascular tumors of bone that most often occur in the vertebral bodies and craniofacial bones. Patients typically present with an asymptomatic lesion found incidentally on radiographs.
- Diagnosis is made with radiographs showing lytic lesions with characteristic vertical striations and with biopsy showing cavernous lesions with numerous thin-walled blood vessels.
- Treatment is observation for asymptomatic lesions. Surgical curettage and bone grafting is indicated in progressively painful lesions.

Presentation
- Symptoms
  - may be asymptomatic
  - may present with pain or pathologic fx

Imaging
- Radiographs
  - lytic lesion characteristic vertical striations giving a "honey-comb" or "jail-bar" appearance
  - may be multi-focal
- Bone scan is warm to hot

Histology
- Characteristic histology
  - cavernous lesions with numerous thin walled blood vessels