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Case Reports
. 2021 Nov 4:9:767927.
doi: 10.3389/fped.2021.767927. eCollection 2021.

Successful Outcome After Intralesional Curettage for Spindle Cell Hemangioma of Fibula in an Infant: A Case Report

Tao Han  1 , Rufa Wang  2 , Xiaoguang Zhou  3
Affiliations
Case Reports

Successful Outcome After Intralesional Curettage for Spindle Cell Hemangioma of Fibula in an Infant: A Case Report

Tao Han et al. Front Pediatr. .

Abstract

Spindle cell hemangioma (SCH), a non-neoplastic reactive vascular lesion, rarely locates in bones. We herein report a successful case of intralesional curettage for an infant with SCH of fibula. An 11-month-old boy was admitted to our center with a painless mass in the right proximal calf. Preoperative digital radiograph demonstrated a massive vascular lesion with an irregular bone destruction of proximal fibula. The lesion was removed via the intralesional curettage approach and pathologically diagnosed as SCH. The patient gained bone structure recovery of right proximal fibula. Two years after the surgery, he experienced no local recurrence. For the management of SCH of fibula with partial bone destruction, we suggest early-stage intralesional curettage as its safety and effectiveness.

Keywords: fibula; intralesional curettage; outcome; spindle cell hemangioma; vascular lesions.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Digital radiograph preoperatively: (A,B) Radiographs of the right tibia and fibula showing an irregular bone destruction of proximal fibula; (C,D) 3d CT reconstruction demonstrating lytic bone destruction of right proximal fibula; (E,F) MRI revealing a massive vascular tumor with surrounding soft tissue hyperplasia and involvement of the proximal fibular epiphyseal plate.
Figure 2
Figure 2
The photograph during the surgery: (A) Intraoperative image of the surgical finding of a vascular mass attached to proximal fibula; (B) Complete curettage of lesion to normal fibular surface; (C) Macroscopic appearance of the excised lesion.
Figure 3
Figure 3
Histopathological features: (A) (HE, ×40) the fissure-like vessel lumens lined with flattened endothelial cells among the spindle cells, (B) (HE, ×100), (C) (HE, ×200) the spindle shaped cells arranging in fascicular pattern in solid area. Immunohistochemical analysis revealing positive staining for (D) CD31 (×100), (E) CD34 (×100), and (F) ERG (×100) in the majority of spindle cells.
Figure 4
Figure 4
Digital radiograph at 2 years postoperatively: (A,B) Radiographs showing reformation of the cortex of the proximal fibula; (C,D) 3d CT reconstruction demonstrating both uniform bone mineral density and continuous cortical of right proximal fibula; (E,F) MRI revealing remarkable regression of lesion without evidence of local recurrence.
See this image and copyright information in PMC

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