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Bisphosphonates as a therapeutic choice for multifocal epithelioid hemangioma of bone: A case report.
- Source :
-
Medicine [Medicine (Baltimore)] 2019 Nov; Vol. 98 (48), pp. e18161. - Publication Year :
- 2019
-
Abstract
- Rationale: Epithelioid hemangioma (EH) of bone is an intermediate vascular tumor that can be locally aggressive. The optimum management of multifocal EH of bone is not well delineated. We described our experience treating one patient with multifocal EH of bone in an effort to document the effect of bisphosphonates in bone EH.<br />Patient Concerns: In this report, a 53-year old male patient presented with back pain which was initially been diagnosed of multiple bone metastatic carcinoma by 18F-FDG PET/CT scan and bone scintigraphy.<br />Diagnosis: CT-guided bone biopsy of ilium indicated that puncture tissue had irregular hyperplasia of thick and thin-walled blood vessels, immunohistochemistry revealed positive staining for CD31 and CD34, negative for CAMTA-1, PCK and EMA, which confirmed the diagnosis of multiple EH.<br />Interventions: The patient was treated with 4 times of intravenous Zometa (zoledronate, 4 mg each time) with average three-month interval. Bone metabolic markers including serum bone specific alkaline phosphatase (BALP) and type I collagen cross-linked C-terminal telopeptide (CTX) levels were closely monitored before and after use of bisphosphonates each time.<br />Outcome: BALP and CTX were significantly lowered following intravenous Zometa and the back pain improved with integrated therapy including bone graft fusion internal fixation surgery and vertebroplasty.<br />Conclusions: EH of multiple bones responded favorably to intravenous Zometa with improvement of bone metabolic markers. After 1 year on follow-up, the patient was doing well with no significant pain. We suggest that bisphosphonates should be considered in the treatment of multifocal osteolytic EH of bone.
- Subjects :
- Biopsy methods
Bone Density Conservation Agents administration & dosage
Bone Remodeling drug effects
Combined Modality Therapy
Diagnosis, Differential
Diphosphonates administration & dosage
Drug Monitoring methods
Humans
Male
Middle Aged
Treatment Outcome
Bone Neoplasms diagnosis
Bone Neoplasms metabolism
Bone Neoplasms pathology
Bone Neoplasms therapy
Bone and Bones diagnostic imaging
Bone and Bones metabolism
Bone and Bones pathology
Hemangioendothelioma, Epithelioid diagnosis
Hemangioendothelioma, Epithelioid metabolism
Hemangioendothelioma, Epithelioid pathology
Hemangioendothelioma, Epithelioid therapy
Immunohistochemistry methods
Neoplasm Metastasis diagnosis
Orthopedic Procedures methods
Zoledronic Acid administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 98
- Issue :
- 48
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31770261
- Full Text :
- https://doi.org/10.1097/MD.0000000000018161