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Year : 1999  |  Volume : 9  |  Issue : 4  |  Page : 201-202
Primary giant intradiploic hemangioma : CT appearance


Department of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, India

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How to cite this article:
Thulkar S, Sharma S, Vashisht S. Primary giant intradiploic hemangioma : CT appearance. Indian J Radiol Imaging 1999;9:201-2

How to cite this URL:
Thulkar S, Sharma S, Vashisht S. Primary giant intradiploic hemangioma : CT appearance. Indian J Radiol Imaging [serial online] 1999 [cited 2018 Apr 23];9:201-2. Available from: http://www.ijri.org/text.asp?1999/9/4/201/28356
Sir,

We read with interest the recent article by Singh S et al describing imaging features of a primary giant intradiploic hemangioma [1]. We also encountered a similar case, which had comparable radiographic and CT features.

A 28-years-old man presented with a long standing, painless, hard swelling in the right frontal region. He also had signs of raised intracranial pressure. The skull radiograph showed a well-circumscribed, expansile lesion with a sunburst pattern of bony striations. The CT showed a large intradiploic lesion with marked expansion of both the inner and outer skull tables and mass effect on the cerebral parenchyma. The standard (8 mm collimation) CT sections when viewed on bone window images showed an intradiploic expansile lesion with a granular bony matrix, though the trabecular striations were not clearly seen [Figure - 1]. CT performed with thin (2 mm) collimation however clearly showed the pathognomonic striations [Figure - 2].

Approximately 20 per cent of osseous hemangiomas occur in the skull [2]. The frontal area is the typical site for a calvarial hemangioma where it produces a convex external bulge [3],[4],[5]. While plain radiographic features are nearly pathognomonic in the skull and spine, a biopsy may be required if it occurs at other sites [2]. Plain radiographic appearances of a calvarial hemangioma include a `sunburst' pattern in which striations radiate from the centre of the lesion. This familiar appearance though clearly visible on plain radiographs, is sometimes not so well demonstrated on CT scans with standard 8mm or 10mm slice thickness. Instead, a coalescing granular type of bony matrix is seen. This appearance probably results from the partial volume effect of the thin trabeculae. This pattern of a granular bony matrix and poor depiction of typical striations can also be seen in many published CT images, including the one by Singh S [1],[4],[5]. We feel that the pathognomonic trabecular pattern of calvarial hemangiomas can be better appreciated with thin CT sections.



 
   References Top

1.Singh S, Raghuram L, Athyal RP, Korah IP. Images: Primary giant intradiploic hemangioma. Ind J Radiol Imaging 1998; 8:183-186.   Back to cited text no. 1    
2.Conway WF, Curtis WH. Miscellaneous lesions of bone. RCNA 1993; 31: 339-358.   Back to cited text no. 2    
3.Dorfman HD, Czerniak B.Vascular lesions. In: Dorfman HD, Czerniak B, eds. Bone tumours, 2nd edn. St. Loius: Mosby, 1998: 729-815.   Back to cited text no. 3    
4.Bastung D ortiz O, Sydney S. Hemangiomas in calvaria: imaging features. AJR 1995; 164: 683-687.   Back to cited text no. 4    
5.Sood S, Vashisht S, Betharia SM, Berry M. CT evaluation of orbital osseous hemangioma. Australas Radiol 1992; 36: 124-126.   Back to cited text no. 5  [PUBMED]  

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Correspondence Address:
Sanjay Thulkar
Department of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


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[Figure - 1], [Figure - 2]



 

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