Hemangioendothelioma is a rare vascular tumor that is infrequently recognized in bone. It can be multicentric and often painful with an indolent course. The treatments of choice include curettage, resection, radiation, systemic medications or a combination of these modalities.

O.G. 5 years old girl, presented with left ankle pain and limping, without response to non steroidal anti-inflammatory drugs for few months. Radiological investigation (MRI) showed a lytic vascular lesion in the methadiaphysis, invading the epiphysis of the distal left tibia and lateral cartilage of the ankle, with atrophy of the left lower limb. Bone scan showed high uptake in this area. Histology showed fragments of bone, infiltrated by a vascular lesion with nodular pattern, well differentiated vascular spaces and endothelial cells with few mitotic figures. Immunostains were positive for CD31 and F8. The pathology report confirmed hemangioendothelioma.

As the lesion invaded the growth plate of the distal tibia, surgical or radiation therapy at this age could cause a permanent damage. We therefore successfully treated the child with Interferon α–2β 0.5 million IU three times a week for 18 months. She was pain free after the first few months of therapy with full recovery of daily function and activity. Radiological evaluation showed improvement on X-ray and MRI, and shrinkage of the lesion to the epiphysis area only.

Unfortunately, 3 years later the pain and limping reappeared. MRI showed a lytic lesion in the diamethaphysis of the left tibia. Re-biopsy supported the diagnosis of recurrent hemangioendothelioma. She was retreated with Interferon α–2β using the same protocol with considerable improvement of the pain and limping.

We present here a non invasive option for therapy with Interferon α–2β for bony lesion of hemangioendothelioma that enable us to spare the growth plate in a growing prepubertal child.