Work

Unusual button sequestrum in multifocal epithelioid hemangioma of bone: A case report and literature review

Year: 2025

Type: article

Abstract: Epithelioid hemangioma is a rare, low-grade vascular tumor defined by epithelioid endothelial differentiation. It has no pathognomonic clinical, laboratory, or imaging features, and its inconsistent nomenclature has historically complicated diagnosis. Although bone involvement is frequent and most lesions behave benignly, some demonstrate local aggressiveness or multifocal spread. We report a unique case of widespread bone lesions exhibiting a "button sequestrum" pattern, previously not described in epithelioid hemangioma. Pathologically, button sequestrum comprises a central island of devitalized bone surrounded by a lucent zone of granulation tissue, a finding that usually narrows the differential diagnosis. Recognizing this presentation broadens the known imaging spectrum of epithelioid hemangioma.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2025.06.121

Authors: Larissa Girardi Sangoi, Joel Del Bel Pádua, Mateus de Andrade Hernandes, Marcello Henrique Nogueira-Barbosa, Leonor Garbin Savarese

Institution: Universidade de São Paulo

Language: English

Topic: Vascular Malformations and Hemangiomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600