• Kyungsoo Bae, Hyo Jung An, Jae Jun Jung, Ho Cheol Kim, and Kyung Nyeo Jeon.
• Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju.
• Medicine (Baltimore). 2020 Sep 25; 99 (39): e22495.

RationaleCavernous hemangioma is a benign vascular tumor, which very rarely occurs in the lung. When appearing as multiple nodules on chest CT, this tumor can be misdiagnosed as metastatic malignancy.Patient ConcernsA 72-year-old woman presented with incidentally found multiple lung nodules on chest radiograph.DiagnosesBased on information derived from dual-layer spectral CT images, the possibility of slow flow vascular tumor such as cavernous hemangioma was suggested. A pathologic diagnosis of pulmonary cavernous hemangioma was made via video-assisted thoracoscopic biopsy.InterventionsAfter tissue confirmation, the patient was discharged without further intervention.OutcomesThe patient recovered without any event. Follow-up chest CT performed 6 months later showed no significant interval change in nodule size and distribution.LessonsMaterial decomposition images obtained from dual energy CT can help physicians understand the character of tumor vascularity for an accurate diagnosis of pulmonary cavernous hemangioma.

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