Intraosseous Hemangioma of the Iliac Bone: An Incidental Finding Mimicking Metastatic Disease

Intraosseous hemangiomas are rare benign vascular tumors predominantly occurring in the axial skeleton. This case report describes a 44-year-old female with a history of multiple renal stones and benign breast calcifications, who was incidentally found to have a 1.2 cm lucent lesion in the left iliac bone during imaging for nephrolithiasis. Initial concerns for metastatic disease prompted further evaluation, including bone scans and multiple biopsies. The first biopsy revealed benign bone tissue with blood elements, while a subsequent computed tomography (CT)-guided biopsy confirmed the diagnosis of an intraosseous hemangioma through the identification of benign vascular elements and adipose tissue, supported by positive immunohistochemical staining for CD34 and CD31. Accurate diagnosis relies on comprehensive imaging and histopathological evaluation to differentiate them from malignant lesions. Correct identification prevents unnecessary surgical interventions and minimizes associated risks. Conservative management is generally effective for asymptomatic cases, ensuring positive patient outcomes.