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Age / Sex : /
Age / Sex : 19/M
Chief complaint : Recently growing palpable mass on the occipital area (onset: 5 years ago)
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
* Send Application Answers to Ja-Young Choi, MD ([email protected])
Courtesy : Sang Min Lee, MD Department of Radiology, Pochon CHA University Bundang CHA General Hospital
Diagnosis: hemangioma
Discussion
Findings:
1. Skull plain radiography and brain CT: A radiolucent, expansile, well-defined intraosseous lesion with a radiating trabecular pattern on right parietooccipital region of the skull
2. MRI: T2WI – high signal intensity, T1WI – low signal intensity with some fatty component, postcontrast T1WI – strong enhancement
Discussion:
1. The two most common sites of involvement are the vertebrae and the skull or facial bones.
2. A radiolucent, slightly expansile, well-defined intraosseous lesion possessing a radiating, lattice-like, or weblike trabecular pattern
3. High signal intensity on T1- and T2-weighted spine echo MR images; these areas are related to the presence of fatty marrow intimate with the dilated vascular channels within the tumor. Such signal intensity characteristics are not seen uniformly, however. Enhancement of signal intensity after the intravenous administration of a gadolinium compound is typical of hemangiomas.
References:
Resnick. Bone and joint imaging, 3rd edi. Elsevier Saunders. Philladelphia. 2005. 1172-1174.
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