In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. The images for this month’s challenge were submitted by Valerae O. Lewis, MD, who provided the following information:
The patient is a 57-year-old man, who complained of pain when sitting. The pain was localized to the sacral region and radiated to the left hip. He also noted pain in the left lower extremity. He denied bowel and bladder problems but noted some diminished sexual function and difficulty maintaining an erection. Conservative treatment was ineffective. Evaluation revealed a mass in the sacrum with some erosion of the sacrum. A small specimen initial biopsy was inconclusive. What’s your diagnosis?
Do you have a challenging case you’d like to submit for publication? E-mail a short case description and any accompanying images to email@example.com
Find the answer to this month’s challenge below.
This month’s challenge appears concerns a 57-year-old man, who experiences pain when sitting; the pain is localized to the sacral region with radiation to the left hip. The initial evaluation revealed a mass in the sacrum with some erosion of the sacrum, but a small specimen biopsy was inconclusive.
According to Valerae O. Lewis, MD, who submitted the case, the differential diagnosis might include a vascular lesion such as hemangioma, hemangioblastoma, or hemangiosarcoma, or a sarcoma of fatty origin such as a liposarcoma. The correct answer is hemangioma, reports Dr. Lewis.
Do you have a challenging case you’d like to submit for publication? E-mail a short case description and any accompanying images to firstname.lastname@example.org.