Learning objectives
Cavernous haemangiomas account for about 7% of all benign vascular tumors and very rarely cause gastrointestinal or genitourinary tract bleeding [1].
These lesions are characterized by a large number of normal or abnormal vessels filled with blood.
When these lesions involve multiple organs the condition is called as angiomatosis or hemangiomatosis [2].
We present a case of diffuse hemangiomatosis in an elderly lady who had extensive involvement of rectum,
urinary bladder,
pelvic soft tissues,
perineum,
muscles,
liver,
spleen,
retroperitoneum and vertebrae.
Background
A 50 yr old lady presented with complaints of haematuria for duration of two months.
There were no other associated complaints or co-morbidities.
Imaging findings OR Procedure details
Radiograph of the pelvis revealed a soft tissue density lesion occupying the pelvic cavity causing complete obliteration of rectal and urinary bladder outlines with multiple,
well defined,
calcified,
round to oval nodular opacities seen scattered in the pelvis overlying the pelvic soft tissue lesion [Fig 10].
Most of these calcific opacities showed central lucency.
She underwent a contrast enhanced CT scan of the abdomen and pelvis which revealed an irregular,
lobulated,
infiltrating,
heterogeneously enhancing mass lesion extending anteriorly to involve the posterosuperior walls of the...
Conclusion
Diffuse haemangiomatosis is a rare cause of haematuria however with a high index of clinical suspicion coupled with typical imaging findings as described; it can be reliably diagnosed.
Imaging plays a vital role not only in the diagnosis but also in evaluating the extent of spread which will aid in surgical planning.
Personal Information
Dr A Alam
Prof & Head
Dept of Radiodiagnosis & Imaging
Command Hospital (Air Force)
Bangalore-560007
India
Dr S Sahu
Asst Prof
Dept of Radiodiagnosis
Institute of Aerospace Medicine
Bangalore-560017
References
1) Bortz JH.
Diffuse cavernous hemangioma of the rectum and sigmoid.
Abdominal Imaging 1994; 19:18 -20.
2) Marinis A,
Kairi E,
Theodosopoulos T,
Kondi-Pafiti A,
Smyrniotis V.
Right colon and liver hemangiomatosis: A case report and review of literature.
World J Gastroenterology 2006; 12(39): 64-6407.