Journal of Postgraduate Medicine
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Year : 1978  |  Volume : 24  |  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

Correspondence Address:
V K Pratap
Departments of Pathology, Radiology and Surgery, L.L.R.M. Medical College, Meerut, Uttar Pradesh
India

Abstract

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;24:60-61


How to cite this URL:
Pratap V K, Rohatgi V K, Dube K N, Mishra S D, Kunwar M. Hemangioma of clavicle- (a case report). J Postgrad Med [serial online] 1978 [cited 2023 Apr 1 ];24:60-61
Available from: https://www.jpgmonline.com/text.asp?1978/24/1/60/42689


Full Text

 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 [2] in year 1917. Radiological characte­ristics of haemangioma of bodies of spinal vertebrae have been emphasized by Bucy and Capp. [1] Reviewing the literature, Wat­son and McCarthy [5] reported only 5 cases of benign haemangioma of bone in a fairly large series of 1056 cases of vascular tumours of all types. Sherman [4] 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 [3] 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.

Gross Pathology

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.

Histology

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". [3] 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

1Buey, P. C. and Capp, C. S.: Primary heamangioma of bone with special refer­ence to roentgenographic diagnosis. Amer. J. Roentgenol. 23: 1-33, 1930.
2Hitzrot, J. M.: Heamangioma caverno­sum of bone. Ann. Surg. 65: 476, 1917.
3Lichtenstein, L.: "Bone Tumours" 3rd Edition. The C. V. Mosby and Co. St. Louis. 1965, p. 160.
4Sherman, M. S.: Capillary hemangioma of bone. Arch. Path. 38: 158-161, 1944.
5Watson, W. L. and McCarthy, W. D.: Blood and lymph vessel tumours. A re­port. of 1056 cases. Surg. Gynaec. Obstet. 71: 569-586, 1940.

 
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