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|Year : 1978 | Volume
| Issue : 1 | Page : 60-61
Hemangioma of clavicle- (a case report)
VK Pratap, VK Rohatgi, KN Dube, SD Mishra, M Kunwar
Departments of Pathology, Radiology and Surgery, L.L.R.M. Medical College, Meerut, Uttar Pradesh, India
V K Pratap
Departments of Pathology, Radiology and Surgery, L.L.R.M. Medical College, Meerut, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
A case of a solitary, localized, benign hemangioma of the clavicle with a pathological fracture is presented. There was no evidence of any other blood vessel being affected. The hemangioma did not cause any signs and symptoms. The literature on this subject is briefly reviewed.
|How to cite this article:|
Pratap V K, Rohatgi V K, Dube K N, Mishra S D, Kunwar M. Hemangioma of clavicle- (a case report). J Postgrad Med 1978;24:60-1
| :: Introduction|| |
Benign vascular lesions of bone are rather rare neoplasms, posing formidable query both radiologically and clinically. First description of a localized cavernous haemangioma of bone was given by Hitzrot  in year 1917. Radiological characteristics of haemangioma of bodies of spinal vertebrae have been emphasized by Bucy and Capp.  Reviewing the literature, Watson and McCarthy  reported only 5 cases of benign haemangioma of bone in a fairly large series of 1056 cases of vascular tumours of all types. Sherman  surveyed more than 60 cases of haemangioma of bone recorded in the literature and reported that the commonest location is the skull bone followed by the long bones of the extremities. Only in rare instances the innominate bones, tarsal bones and scapula are the sites of origin although haemangioma of vertebral bodies is reported with fair frequency in the literature. However Lichtenstein  opines that a certain number of these might actually be instances of "aneurysmal bone cysts". Solitary localized benign lesions present a symmetrical fusiform cystic appearance with marked expansion of the bone and eventual thinning of the cortex, presenting characteristic "sun-burst" appearance roentgenographically but trabeculations and honey combing are not uncommon features.
| :: Case report|| |
B., a 12 year old boy, was admitted at the S.V.B.P. Hospital, Meerut with a history of fall from a height of nearly 10 feet three days perior to admission and pain in the left shoulder region. The patient was of average build and normal health. Local examination revealed a painful fusiform swelling of nearly 5 cms. in diameter in the middle of the clavicle and a pathological fracture at the junction of the middle and the outer third of the bone. Roentgenographically, the clavicle showed cystic. osteoporotic and trabeculated appearance with a pathological fracture See [Figure 1] on page 59B) . Clinically, diagnosis of osteoclastoma of the left clavicle was made; a portion of the expanded bone was excised and specimen was submitted for histopathological examination. The patient made an uneventful recovery and was discharged as cured.
The portion of clavicle with an expanded fusiform swelling at one end of the specimen, measured 6 x 4 x 2.5 cms. Cut surface presented multilocular cyst filled with haemorrhagic material.
Histologically it consisted of a meshwork of engorged, thin walled blood vessels lined with endothelium in loose connective tissue stroma. The characteristic picture of cavernous haemangioma was discernible See [Figure 2] on page 59B.
| :: Discussion|| |
The presence of a solitary, localized, benign haemangioma of the clavicle with a pathological fracture is presented. The patient was completely unaware of its existence before he sustained a pathological fracture after a fall. As emphasized by various authorities, haemangiomas of bone rarely cause symptoms and most often than not they may be detected on careful examination at autopsy. Clinical presentation and roentgenographic appearance pose a formidable problem of differential diagnosis and actually certain number of reported haemangiomas might represent instances of "aneurysmal bone cysts".  The present case required a little pondering before a diagnosis of haemangioma of clavicle was made. It was a solitary lesion without any evidence of any other blood vessel being affected.
| :: References|| |
|1.||Buey, P. C. and Capp, C. S.: Primary heamangioma of bone with special reference to roentgenographic diagnosis. Amer. J. Roentgenol. 23: 1-33, 1930. |
|2.||Hitzrot, J. M.: Heamangioma cavernosum of bone. Ann. Surg. 65: 476, 1917. |
|3.||Lichtenstein, L.: "Bone Tumours" 3rd Edition. The C. V. Mosby and Co. St. Louis. 1965, p. 160. |
|4.||Sherman, M. S.: Capillary hemangioma of bone. Arch. Path. 38: 158-161, 1944. |
|5.||Watson, W. L. and McCarthy, W. D.: Blood and lymph vessel tumours. A report. of 1056 cases. Surg. Gynaec. Obstet. 71: 569-586, 1940. |
[Figure 1], [Figure 2]