Hemangioma of Tibia

There is an expansile lesion of the proximal left tibia. It extends to the subchondral surface.
Although cortical thinning is present, the lesion does not appear to have penetrated the cortex.
The lesion is geographic with a web or lattice-like configuration.
No soft tissue masses, unusual calcifications, or periostitis are seen.
- A detailed view of the lesion demonstrates these findings.
This biopsy proven lesion was known to be long-standing and asymptomatic.

Findings are compatible with hemangioma (although a radiographic differential diagnosis does exist).

You may wish to review some facts concerning hemangiomas:

Hemangiomas are composed of vascular channel which may be cavernous, capillary, or venous.
- Usually a solitary, asymptomatic lesion discovered in a middle- aged patient.
- Symptoms, when they do occur, relate to site -- compression in spine, hemi-hypertrophy and spasm in long bones.
F:M 2:1.
Usually found in spine (vertically oriented trabeculae) and skull (star-burst appearance).
Rare in long bones.
- Lattice-like appearance corresponds to vascular spaces.
- Cortical thinning and expansion may occur.
- No periostitis.
- Considered a benign lesion.
DDx includes giant cell tumor, aneurysmal bone cyst, adamantinoma (angioblastoma), chondromixoid fibroma, other "bubbly" lesions of bone.

Ref: Resnick, D., Bone and Joint Imaging, W.B. Saunders, Philadelphia, PA, 1989, pp. 1156-1162.