Pediatric Scapular Cavernous Hemangioma Presenting with Kasabach-Merritt Syndrome and Controlled by Preoperative Angioembolization: A Case Report

Intraosseous hemangioma is a common and benign vascular tumor with a propensity to occur in any bone of the body. Although the most common skeletal sites are the craniofacial bones and the spine, hemangioma of the scapula is a rare occurrence, which is rarer in the pediatric population. Kasabach-Merritt syndrome (KMS) is characterized by the combination of a rapidly growing vascular tumor, thrombocytopenia, microangiopathic hemolytic anemia, and consumptive coagulopathy. This condition can cause massive bleeding even after minor trauma and immediate operative management is usually contraindicated. We report a rare case of KMS in an 8-year-old girl with cavernous hemangioma of the scapula presenting with progressively increasing shoulder mass, thrombocytopenia, and serially falling hemoglobin levels. She was treated with preoperative angioembolization to manage the consumptive coagulopathy followed by surgery poststabilization. Intraosseous hemangiomas, while benign, can show aggressive features on imaging and angioembolization can be a life-saving tool in the management of vascular tumors presenting with consumptive coagulopathy. Intraosseous hemangiomas, while benign, can show aggressive features on imaging and angioembolization can be a life-saving tool in the management of vascular tumors presenting with consumptive coagulopathy.