Multimodal Percutaneous Treatment of an Aggressive Intraosseous Hemangioma of the Pelvis

Abstract

A 51-year-old man with a history of ankylosing spondylitis presented with gradually increasing right hip pain. Computed tomography and magnetic resonance imaging demonstrated a large lytic lesion of the right iliac bone. Percutaneous bone biopsy was performed, followed by a diagnosis of an aggressive bone hemangioma. After a multidisciplinary meeting, sequential interventional treatment combining arterial embolization, percutaneous cryoablation, and cementoplasty was proposed and performed under imaging guidance, resulting in a complete resolution of symptoms. The patient presented a local recurrence at 4 years posttreatment, managed successfully with percutaneous cementoplasty under computed tomography guidance.

Key Points

• - Multidisciplinary management approach is warranted to yield optimal outcomes in patients with aggressive bone hemangiomas.

• - Percutaneous cryoablation can be considered as an alternative treatment option for symptomatic bone hemangioma, especially when tumor size reduction is desired.

• - When treating vascular bone tumors with percutaneous cryoablation, preoperative arterial embolization may not only reduce hemorrhagic risks but also improve local tumor control by preventing the so-called cold sink effect.

Keywords

hemangioma - cryoablation - cementoplasty

Publication History

Received: 27 August 2025

Accepted: 10 November 2025

Article published online:
20 February 2026

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