Periosteal spindle cell hemangioma of the fibula: a case report

Skeletal Radiol. 2013 Aug;42(8):1165-8. doi: 10.1007/s00256-013-1603-x. Epub 2013 Mar 24.


Spindle cell hemangioma is a rare benign tumor characterized by cavernous blood vessels and spindle cell proliferation. It typically arises in the subcutis of the distal extremities, particularly in the hand. Spindle cell hemangioma of periosteal origin is extremely rare, and our extensive literature search did not find any reports of this condition. We report here a case of spindle cell hemangioma of periosteal origin arising from the right fibula of a 49-year-old woman. Pathological examination of a needle biopsy specimen indicated the possibility of low-grade spindle cell sarcoma, and the patient underwent resection of the fibular diaphysis with a wide margin. Subsequent examination of the surgical specimen revealed a diagnosis of periosteal spindle cell hemangioma. Follow-up examination at 10 months showed no evidence of local recurrence or metastasis. A large tissue sample was required for definitive diagnosis in this case. Spindle cell hemangioma behaves in a benign fashion, but recurrence occurs in about 60% of cases. Excision of the fibula was a reasonable course of management in this case because these patients usually maintain good function. Reports of additional cases will be required to determine the most appropriate treatment for this tumor.

Publication types

  • Case Reports

MeSH terms

  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / surgery*
  • Diagnosis, Differential
  • Female
  • Fibula / diagnostic imaging*
  • Fibula / pathology*
  • Fibula / surgery
  • Hemangioma / diagnosis*
  • Hemangioma / surgery*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Periosteum / diagnostic imaging
  • Periosteum / pathology
  • Periosteum / surgery
  • Sarcoma / diagnosis*
  • Sarcoma / surgery
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome