A unique case of benign intracranial hemangioma mimicking malignant transformation

Abstract

Capillary hemangiomas are rare benign vascular lesions, commonly found on scalp, face, chest, or back of a neonate or infant. Hemangiomas of the central nervous system are very rare lesions. There are only a few cases of intracranial capillary hemangioma (ICH) arising in adults reported in the literature. We present a case of 59-year-old female with intermittent recurrent headache localized in the frontal area. Magnetic resonance imaging revealed left frontal extra-axial mass with peripheral enhancement. The patient underwent complete surgical resection of the tumor. Histopathology examination of the lesion revealed well defined vascular lesion composed of closely packed plump endothelial cells lining slit-like vascular channels containing scattered red blood cells. No evidence of infiltrative brain parenchyma was seen. Ki-67 proliferative index was low, less than 2%. The final diagnosis was confirmed to be ICH by histopathology and immunohistochemistry studies. The patient has remained healthy and free of disease 39 months since her initial surgery. ICH is a benign vascular lesion which rarely occurs in the central nervous system, particularly in the intracranial region. It can mimic malignant lesions on radiologic studies. Histopathology examination is the gold standard for diagnosis. If total resection is achieved, prognosis is generally good with no evidence of recurrence.

Capillary hemangioma of the sphenoid sinus with intrasellar and parasellar extensions

“…Occasionally, the radiographic appearance mimics meningiomas [7] . Capillary hemangiomas display enhancement after contrast administration, and some cases may present with a peripheral enhancement pattern [13] . Avid enhancement on post-contrast T1-weighted images and hyperintensity with flow voids on T2-weighted images indicate high vascularity and strongly suggest capillary hemangioma [14] , although flow voids have not been reported in all cases.…”

Intracranial, Intra-parenchymal Capillary Hemangioma – Case Report –

“…On the basis of their locations and, most of them were diagnosed as meningioma before surgery. [1][2][3][4][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Interestingly, intracranial capillary hemangioma may arise from the ethmoid and sphenoid sinuses, infundibular recess, fourth ventricle, and anterior choroidal artery as an extra-axial mass. [20][21][22][23] In fact, capillary hemangioma is only presented as an intraosseous form in the skull in WHO Classification of Tumours of the Central Nervous System Revised 4th Edition.…”

Documented growth of an intracranial capillary hemangioma: A case report

“…1 More commonly seen in newborns and children, especially in the skin, capillary hemangiomas are rare in adults, particularly in the central nervous system. 1 On gadoliniumenhanced brain magnetic resonance imaging (MRI), these lesions are isointense on T1-and hyperintense on T2-weighted images. 2 Because patients are usually not imaged in the presymptomatic phase, the rate of growth of the hemangiomas is unclear.…”

“…Capillary hemangiomas consist of unencapsulated lobular capillary masses whose channels are lined by endothelial cells and pericytes without overlying smooth muscle. The channels can be separated by interstitial collagen 1 . More commonly seen in newborns and children, especially in the skin, capillary hemangiomas are rare in adults, particularly in the central nervous system 1 .…”

“…The channels can be separated by interstitial collagen 1 . More commonly seen in newborns and children, especially in the skin, capillary hemangiomas are rare in adults, particularly in the central nervous system 1 . On gadolinium‐enhanced brain magnetic resonance imaging (MRI), these lesions are isointense on T1‐ and hyperintense on T2‐weighted images 2 .…”