CTICasesIntraosseous Hemangioma of the Rib
Imaging findings
Chest CT in an asymptomatic 17-year-old female shows a well-circumscribed, expansile mass within the posterior aspect of a rib, demonstrating a cortical defect and a sunburst-like periosteal reaction with prominent internal trabeculations. MRI confirms the mass is highly T2-intense with internal flow voids and intense, homogeneous enhancement. Biopsy reveals dilated venous channels consistent with a benign vascular malformation/intraosseous hemangioma.
Key takeaways
Intraosseous hemangiomas of the ribs are rare, benign vascular tumors that typically occur in young individuals. On CT, they present as expansile lytic bone lesions with a characteristic 'spoked-wheel' or 'honeycomb' trabecular pattern and cortical thinning. They can mimic aggressive primary bone malignancies (such as Ewing's sarcoma or osteosarcoma) on CT, but the classic MRI features of high T2 signal and flow voids help guide a conservative approach.
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