"Soap Bubble" Lesion of the Middle Phalanx: Enchondroma or Epitheloid Hemangioma

Abstract

Introduction: Epitheloid hemangioma, a benign vascular tumor that arises in skin and soft tissues can also involve the skeletal system. Occasionally this has been reported from small tubular bones of the hand.

Case report: Authors report a case of epitheloid hemangioma of the middle phalanx in a young girl without any cutaneous manifestations. The lesion presented as a swollen middle finger, and plain radiographs showed a geographic area of destruction with cortical thinning and intra lesional calcifications. The case was managed by curettage and bone grafting. Histology confirmed this as a case of epitheloid hemangioma.

Conclusion: Epitheloid hemangioma should be considered in the differential diagnosis of hand masses with expansile lytic lesions with cortical thinning.

Keywords: Enchondroma; Epitheloid hemangioma; Hand; Vascular tumor.

Figure 1

Plain Radiographs Showing Expansile Lesion of the Middle Phalanx with Calcifications.

Figure 2

CT Scan Showing Geographic Destruction, with Bulbous Expansion and Calcifications.

Figure 3

IHC Stain CD 31 Highlighting the Blood Vessels.

Figure 4

Hematoxylin and Eosin Stain Showing Blood Vessels Lined by Plump Eitheloid Cells and Eosinophils in the Stroma X 20.

Figure 5

Clinical Photograph Showing the Range of Movements of the Finger. Figure 5 a & b Showing Range of Movements.

Figure 6

Radiographs Antero-posterior [a] and Lateral [b] Showing no Evidence of recurrence.