骨血管瘤為一慢速生長之良性腫瘤,該腫瘤好發於脊椎骨,顱骨及顏面骨骼。發生於助骨之血管瘤則相當少見。一位有多年氣喘病史的五十六歲婦女在胸部X光攝影中偶然發現一大型助膜外腫塊,併有左側第七肋骨之擴張性破壞。腫塊中並可發現索狀鈣化。胸部電腦斷層攝影顯示該大型腫瘤邊緣完整,由左側第七助里後緣往前延伸。腫瘤中有索狀鈣化及非鈣化兩部份,非鈣化之區域可被顯影劑加強顯影。肋膜腔中無明顯積液,兩側肺葉與縱膈並未發現異常。病人接受腫瘤之切除手術,病理診斷為海綿狀血管瘤。由於助骨之大型血管瘤與其他較常見之助骨惡性腫瘤易造成放射線學上鑑別診斷的困難,並且唯有正確之術前診斷方能提供適當之治療計劃。因此我們提出此一病例報告並回顧相關之文獻。
Osseous hemangioma is a benign neoplasm, rarely located in the ribs. A 56-year-old female patient without specific complaint had a large extrapleural lesion on chest posteroanterior radiograph. Expansile destruction of left seventh rib and relatively fine trabeculation were noticed in the mass from plain roentgenogram and computed to-mography (CT). Contrast enhancement in noncalcified component of the lesion was re-vealed. Pleural effusion, lung parenchymal or mediastinal abnormality were not identi-fied. Resection of the lesion with part of the originating rib was carried out. The patho-logic diagnosis was cavernous hemangioma. We present a case with a large rib hema-ngioma which often leads to difficulty in radiologically differential diagnosis with other common malignant rib tumors. We also review the literature about hemangioma and malignant neoplasms of the ribs.