Ethanol sclerotherapy reduces pain in symptomatic musculoskeletal hemangiomas.
Hemangiomas, benign vascular lesions, require intervention if causing pain or functional limitations. Functional deficits are common after excision, favoring minimally invasive treatments. To determine whether ethanol sclerotherapy reduces pain and lesion size and to assess complications in symptomatic musculoskeletal hemangiomas, we retrospectively reviewed 19 patients (six males, 13 females; mean age, 34 years) meeting criteria of confirmed hemangioma, treatment with ethanol sclerotherapy, and minimum of 6 weeks of followup. Fourteen were primary lesions and five were recurrent; all were painful. Thirty-eight sclerotherapy procedures were performed, with each patient undergoing a maximum of three procedures. Mean followup was 24 months (range, 2-95 months). Four patients reported full pain relief, 11 had partial relief, and four had no relief. With recurrent lesions, one patient had full pain relief, one had partial relief, and three had no relief. For patients with lesions larger than 5 cm, two had full relief, six had partial relief, and three had no relief. Lesion shrinkage occurred in 12 patients. Temporary complications included paresthesiae (three), tendon contracture (one), skin breakdown (one), and deep vein thrombosis (one). Ethanol sclerotherapy afforded prompt pain relief in 15 of 19 patients with hemangioma, making it a reasonable option for initially avoiding surgical excision. However, the short followup of our patients requires additional long-term studies to assess the duration of the results.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Crawford
Eileen A
EA
Department of Orthopaedic Surgery, University of Pennsylvania, Garfield Duncan Building, Suite 2C, 301 South 8th Street, Philadelphia, PA, 19106-6192, USA.
Slotcavage
Rachel L
RL
King
Joseph J
JJ
Lackman
Richard D
RD
Ogilvie
Christian M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000175:diagnosis / Q000628:therapy*; D015331:Cohort Studies; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D018570:Risk Assessment; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult
D000431:Ethanol