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Case No : 1463 Date 2025-11-03
- Courtesy of Woo Heon Lim / Seoul National University Hospital
- Age/Sex 59 / M
- Chief ComplaintLeft flank pain
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Hemangioma of rib
- Radiologic Findings
- Fig. 1. CT scan reveals a radiolucent bone lesion with soap bubble appearance and extraosseous component in the posterior arc of the left 5th rib.
Fig. 2. CT scan obtained 2 years befor suggests growth of the lesion.
Fig. 3-4. MRI shows a T2-hyperintense, T1-hypointense lesion with intense enhancement and no diffusion restriction. - Brief Review
- Involvement of the rib is an extremely rare manifestation of hemangioma. Hemangiomas are usually asymptomatic and are often discovered incidentally. However, large lesions can cause pain and swelling.
On CXR, hemangiomas may exhibit a characteristic sunburst appearance, representing well-defined lytic lesions with thickened trabeculae. On CT, they may show a honeycombed or soap-bubble appearance, consisting of coarsened trabeculae and intervening fat. The presence of phleboliths can be a key diagnostic feature. On MRI, hemangiomas typically show T2 hyperintensity. The signal intensity on T1-weighted images varies depending on the amount of intervening fat but is usually T1 hyperintense. Contrast enhancement is often present.
Surgical excision is the treatment of choice, but preoperative embolization may be required for large lesions. - References
- 1. Deshmukh H, Rathod KK, Hira P, et al. Hemangioma of Rib: A Different Perspective. Pol J Radiol. 2015;80:172–175.
2. Abrao FC, Tamagno M, Canzian M, et al. Hemangioma of the Rib. Ann Thorac Surg. 2011;91:595-596. - Keywords
No. of Applicants : 71
- ▶ Correct Answer : 30/71, 42.3%
-
- - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
- - , Japan SUZUNE TSUKAMOTO
- - The University of Tokyo Hospital , Japan ISSEI FUKUDA
- - Shiga University of Medical Science , Japan AKITOSHI INOUE
- - Kyoto University , Japan AKIHIKO SAKATA
- - Oita university , Japan AYUMI KAMEI
- - Kyoto University Hospital , Japan YUSUKE UTSUNOMIYA
- - , France CHARLES DAMIEN
- - Kyung Hee University Medical Hospital , Korea (South) INKEON YEO
- - Secomedic Hospital , Japan FUMINORI MIYOSHI
- - University of Yamanashi , Japan TAKAAKI HASHIMOTO
- - Osaka University , Japan AKINORI HATA
- - , Japan YOSHIKI ISHII
- - , Japan KENTARO KOTANI
- - , Japan KEISUKE OSHIMA
- - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
- - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- - Shiga General Hospital , Japan YUSAKU MORIBATA
- - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
- - Kyoto University , Japan SHO KOYASU
- - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
- - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
- - Fukuoka university , Japan KEISUKE SATO
- - Matsunami General Hospital , Japan TARO TAKEDA
- - , Japan HITOSHI TAKEUCHI
- - Toyota Kosei Hospital , Japan YUKI HAYASHI
- - Chonbuk National University Hospital , Korea (South) HYEONG RYUN CHO
- - the first affiliatited hospital of nanjing medical univercity , China HAI XU
- - University of Yamanashi , Japan KOJIRO ONOHARA
- - Chonnam National University Hospital , Korea (South) JAEBONG YANG
- ▶ Correct Answer as Differential Diagnosis : 8/71, 11.3%
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- - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
- - Oita university , Japan NORITAKA KAMEI
- - , Japan SHUNJIRO NOGUCHI
- - GHICL , France MANUEL TOLEDANO
- - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
- - , Japan MATSUNO MAI
- - Ehime University , Japan TOMOHISA OKADA
- - Nara medical university , Japan HIROHIDE WATANABE
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