Synchronous presence of two ossified intramuscular hemangiomas of the leg investigated by Tc-99m hydroxymethylene diphosphonate three-phase bone scan and SPECT-CT: case report and literature review
Case report, 156 - 162Tag this article
Hemangiomas are common vascular tumors, but intramuscular ones only account for 0,8%. In most cases these pathologies affect young adults without sex difference. About 45% of intramuscular hemangiomas are located in the lower extremities, frequently resulting in adjacent bone changes. However, vascular proliferation is rarely combined with neo-production of mature bone tissue inside the lesions. The correct preoperative diagnosis has been described between 8% and 19% of cases. A local post-operative recurrence can occur up to 50% of patients (time to recurrence not defined). Here we are reporting the history of a 16-year-old Caucasian male with two coexisting ossified hemangiomas in the skeletal muscle of the right leg. Radiographic, magnetic resonance and histological features of this patient are discussed. Moreover, Tc-99m hydroxymethylene diphosphonate three-phase bone scan (Tc-99m HMDP-BS) and single photon emission computed tomography-computed tomography (SPECT-CT) have shown to be very useful in the preoperative characterization of the lesions and also in the follow-up evaluation.
KEY WORDS: hemangioma; skeletal muscle; metaplastic bone; three-phase bone scan; single photon emission computed tomography-computed tomography.