J Hand Microsurg 2017; 09(03): 154-158
DOI: 10.1055/s-0037-1605355
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Single-Stage Surgery Using Calcium Sulfate Pellets in Association with Tumor Resection as Treatment for Intraosseous Hemangioma of the Radius Shaft in a 2-Year-Old Boy

Antonio Andreacchio
1   Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
,
Flavia Alberghina
1   Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
,
Vanessa Giacometti
1   Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
,
Lorenza Marengo
1   Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, Torino, Italy
,
Federico Canavese
2   Department of Pediatric Surgery, University Hospital Estaing, Clermont Ferrand, France
› Author Affiliations
Further Information

Publication History

10 April 2017

13 July 2017

Publication Date:
01 August 2017 (online)

Abstract

Intraosseous hemangiomas are uncommon benign vascular tumors. Here the authors report a case of intraosseous hemangioma of the radial shaft in a 2-year-old boy, surgically treated by tumor mass resection and application of calcium sulfate pellets with no signs of relapse over a 2-year follow-up. Moreover, the lesion healed with new bone formation, and the last plain radiographs suggested homogenous normal trabecular bone density. The radius grew in length and remodeled to an almost normal shape. Clinically, elbow flexion-extension and forearm pronation and supination were within normal limits at the last follow-up visit.

This report points to calcium sulfate pellets as a valid alternative to autologous bone grafting as void filler in large bone defects. Calcium sulfate pellets enable fast osteoinduction without interfering in follow-up imaging.

 
  • References

  • 1 Chekili S, Abdelghani KB, Hajri R, Laatar A, Mestiri M, Zakraoui L. [Intraosseous capillary hemangioma of the radial bone]. Rev Chir Orthop Repar Appar Mot 2008; 94: 413-416
  • 2 Unni KK. Dahlin's Bone Tumors: General Aspect and Data on 11,087 Cases. 5th ed. Philadelphia, PA: Lippincott-Raven; 1996
  • 3 Song HR, Shyam AK. Juxtaphyseal intraosseous hemangioma of proximal femur causing coxa vara and coxa breva deformity in a growing child. J Orthop Case Rep 2011; 1 (01) 22-25
  • 4 Kaleem Z, Kyriakos M, Totty WG. Solitary skeletal hemangioma of the extremities. Skeletal Radiol 2000; 29 (09) 502-513
  • 5 Bregman JA, Jordanov MI. Epithelioid hemangioma occurring in the radial styloid of a 17-year-old boy-an unusual presentation of an uncommon neoplasm. Clin Imaging 2014; 38 (06) 899-902
  • 6 Wenger DE, Wold LE. Benign vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol 2000; 29 (02) 63-74
  • 7 Doppman JL, Oldfield EH, Heiss JD. Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol. Radiology 2000; 214 (02) 341-348
  • 8 Beuerlein MJ, McKee MD. Calcium sulfates: what is the evidence?. J Orthop Trauma 2010; 24 (Suppl. 01) S46-S51
  • 9 Gitelis S, Piasecki P, Turner T, Haggard W, Charters J, Urban R. Use of a calcium sulfate-based bone graft substitute for benign bone lesions. Orthopedics 2001; 24 (02) 162-166
  • 10 Geschickter CF, Maseritz IH. Primary hemangioma involving bones of the extremities. J Bone Joint Surg 1938; 20: 888-900
  • 11 Sherman MS. Capillary hemangioma of bone. Arch Pathol (Chic) 1944; 38: 158-161
  • 12 Loxley SS, Thiemeyer Jr JS, Ellsasser JC. Periosteal hemangioma. A report of two cases. Clin Orthop Relat Res 1972; 85 (85) 151-154
  • 13 Sugiura I. Tibial periosteal hemangioma. Clin Orthop Relat Res 1975; (106) 242-244
  • 14 Pena JM, Calone JA, Ortega F, Marco A, Martinez A, Saez F. Periosteal hemangioma of left fibula. Case report 324. Skeletal Radiol 1985; 14 (02) 133-135
  • 15 Melchior B, Bensahel H, Desgrippes Y. Lower limb bone hemangiomas in children: report of two cases. J Pediatr Orthop 1991; 11 (04) 482-484
  • 16 Matsumoto K, Ishizawa M, Okabe H, Taniguchi I. Hemangioma of bone arising in the ulna: imaging findings with emphasis on MR. Skeletal Radiol 2000; 29 (04) 231-234
  • 17 Puig J, Garcia-Pena P, Enriquez G, Huguet P, Lucaya J. Intraosseous haemangioma of the ilium. Pediatr Radiol 2006; 36 (01) 54-56
  • 18 Ferrari L, Segura Fonseca JJ. Cavernous hemangioma of the proximal femur. Int J Surg Pathol 2011; 19 (05) 617-619
  • 19 Shinohara T, Tatebe M, Yamamoto M, Kurimoto S, Hirata H. A surface-based hemangioma of the radius which posed radiological diagnostic difficulties. Nagoya J Med Sci 2013; 75 (1-2): 125-129
  • 20 Gourgiotis S, Piyis A, Panagiotopoulos N, Panayotopoulos P, Salemis NS. Cavernous hemangioma of the rib: a rare diagnosis. Case Rep Med 2010; 2010: 254098
  • 21 Van der Stok J, Van Lieshout EM, El-Massoudi Y, Van Kralingen GH, Patka P. Bone substitutes in the Netherlands—a systematic literature review. Acta Biomater 2011; 7 (02) 739-750
  • 22 McKee MD, Wild LM, Schemitsch EH, Waddell JP. The use of an antibiotic-impregnated, osteoconductive, bioabsorbable bone substitute in the treatment of infected long bone defects: early results of a prospective trial. J Orthop Trauma 2002; 16 (09) 622-627
  • 23 Dormans JP, Sankar WN, Moroz L, Erol B. Percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate pellets for unicameral bone cysts in children: a new minimally invasive technique. J Pediatr Orthop 2005; 25 (06) 804-811
  • 24 Kelly CM, Wilkins RM, Gitelis S, Hartjen C, Watson JT, Kim PT. The use of a surgical grade calcium sulfate as a bone graft substitute: results of a multicenter trial. Clin Orthop Relat Res 2001; (382) 42-50
  • 25 Ferguson JY, Dudareva M, Riley ND, Stubbs D, Atkins BL, McNally MA. The use of a biodegradable antibiotic-loaded calcium sulphate carrier containing tobramycin for the treatment of chronic osteomyelitis: a series of 195 cases. Bone Joint J 2014; 96-B (06) 829-836
  • 26 Humm G, Noor S, Bridgeman P, David M, Bose D. Adjuvant treatment of chronic osteomyelitis of the tibia following exogenous trauma using OSTEOSET(®)-T: a review of 21 patients in a regional trauma centre. Strateg Trauma Limb Reconstr 2014; 9 (03) 157-161
  • 27 von Stechow D, Scale D, Rauschmann MA. Minimizing the surgical approach in patients with spondylitis. Clin Orthop Relat Res 2005; 439 (439) 61-67
  • 28 Lee GH, Khoury JG, Bell JE, Buckwalter JA. Adverse reactions to OsteoSet bone graft substitute, the incidence in a consecutive series. Iowa Orthop J 2002; 22: 35-38