Dear Ocaders,
I need your help again, complicated case
Young man with a intramuscular/ paraoseous haemangioma (first biopsy, then embolisation), after 4-5 month since embolisation, the mass is again growing.
Not the mass I am worried, probably it re-growth, but about what is inside the femur.
Osteolitic lesion with ostecondensation inside and a lot a BME arround, an area that is a bit more demarcated that I would expect from BME
Without knowledge about the haemangioma I would have reported it as osteoid osteoma or may osteomyelitis with a small sequestrum.
In the view of the haemangioma information, these bone modifications could be intraoseous vascular malformation with a …phlebolith??
There is vivid enhancement of the bone lesion – the second tricks phase (around 16 second after injection)
Bone pathology seems stable from the first MRI – 6 month. Ostemyelitis would progress I suspect.
Clinically, the patient has moderate pain, AINS helps.
Any ideas?
Thanks in advance
Sorin
