Hemangioma of the Rib Mimicking Chondrosarcoma: A Report of Two Cases and Literature Review.
Hemangioma of the Rib Mimicking Chondrosarcoma: A Report of Two Cases and Literature Review.
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DOI：
10.1155/2021/9996380
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发表时间：
2021
影响因子：
--
通讯作者：
Tanaka S
中科院分区：
文献类型：
--
作者：
Tsuda Y;Kobayashi H;Makise N;Zhang L;Shinoda Y;Ushiku T;Tanaka S
病例1是一名58岁男性，在右侧下腹部偶然发现一个缓慢生长的肿块。影像学检查显示肿块起源于第11根肋骨，边缘不清，皮质破坏。鉴别诊断包括软骨肉瘤和转移性恶性肿瘤。尽管切口小，但开放性活检仍与中度出血（300 mL）相关。显微镜检查发现大量不规则、扩张和薄壁血管，符合骨血管瘤的诊断，并进行了整块切除术，无手术并发症。病例2是一位49岁的男性，在电脑断层扫描时偶然发现第四肋骨肿块伴钙化。根据影像学特征怀疑软骨肉瘤。由于肿瘤位于肩胛骨后方，因此认为开放性活检存在肿瘤种植风险。进行肿瘤整块切除术，未进行活检。病理学表现与骨血管瘤一致。 我们报告两例罕见的血管瘤起源于肋骨，模仿软骨肉瘤。术前诊断在临床和影像学上都具有挑战性。因为肋骨血管瘤的活检与出血风险相关，所以不活检的整块切除可能是一种实用的治疗选择。
Case 1 was a 58-year-old man who presented with an incidentally detected, slowly growing mass in the right hypochondrium area. An imaging study showed the mass arising from the 11th rib, with ill-defined margins and cortical destruction. Differential diagnoses included chondrosarcoma and metastatic malignant tumor. Open biopsy was associated with moderate bleeding (300 mL) despite small incision. Microscopic findings showed numerous irregular, dilated, and thin-walled vessels, consistent with the diagnosis of hemangioma of bone, and en bloc excision was performed with no surgical complication. Case 2 was a 49-year-old man who presented with an incidentally detected 4th rib mass with calcification on computed tomography scan. Chondrosarcoma was suspected according to imaging features. An open biopsy was considered to have a risk of tumor seeding because the tumor was located behind the scapula. En bloc excision of the tumor without biopsy was performed. The pathological findings were consistent with hemangioma of bone. We reported two cases of rare hemangioma arising from the rib, which mimicked chondrosarcoma. The preoperative diagnosis was challenging, both clinically and radiologically. Because biopsy for hemangioma of the rib is associated with a bleeding risk, the en bloc excision without biopsy can be a practical treatment option.
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