Case report of a rare giant bone island in a vertebral body combined with hemangioma

Abstract

This case report describes a rare giant bone island combined with hemangioma diagnosed in a patient with osteolytic vertebral metastases. The bone island's greatest diameter was 3.15 cm, and bone islands of this size are rare in the literature. This article aims to provide clinicians with information about the diagnosis and relevant literature of bone islands.

Keywords: Bone island; case report; hemangioma; osteoblastic metastases; radiographic images; spine.

Figure 1.

Computed tomography (CT) images. a–e: Low-density shadows combined with high- and uniform-density shadows on sagittal and cross sectional views, which differs from bone metastases, which show bone formation within soft tissue density; e: maximum diameter: 3.15 m.

Figure 2.

Magnetic resonance images (MRI). a, b, d and e: High signal intensity (hemangioma) combined with low signal intensity (bone island) in T1-weighted/T2-weighted (T1W1\T2W1) images; c: Most of T7 shows a low signal intensity (bone island) in this T2W1 fat saturation image, whereas bone metastases show a high signal.

Figure 3.

Positron emission tomography-computed tomography (PET-CT) images. a–c: Fence-like trabecular bone, irregular density shadows, and reduced F-18 fluorodeoxyglucose (FDG) uptake or defects (bone island), in contrast to bone metastases, which present with high FDG uptake.

Figure 4.

Pathological findings. a, b: Biopsy of T7; c: Two pieces of bone tissue measuring approximately 0.6 cm in size; d: Postoperative pathology showing the typical characteristic of a bone island: abnormally hyperplastic lamellar bone.