Multifocal Epitheloid Hemangioma of the Bone - A Rare Entity

Introduction: Epithelioid hemangiomas (EHs) are rare vascular lesions which generally affect the skin and subcutaneous tissue but rarely seen in bones. It is a benign entity but intermediate grade, i.e., locally aggressive in nature. It has very confusing clinicoradiological and histopathological features which make diagnosis difficult and help us to avoid inappropriate treatment.

Case report: We present with a 32-year-old male with multifocal EH involving the distal radius, a few carpal bones (trapezium, trapezoid, and capitate), and the base of 2nd and 3rd metacarpals with extensive surrounding soft-tissue involvement. He was managed with intralesional extended curettage + bone grafting and is disease free till follow-up.

Conclusion: As EH is a rare entity, this comes as a differential diagnostic in locally aggressive-looking lytic lesions in the bone which helps the treating orthopedic surgeons or orthopedic oncosurgeons to have this differential in their mind for a better diagnosis and further management.