Aggressive growing of the infantile cavernous hemangioma of the calvaria: a case report and review of literature

A Giant Primary Intraosseous Calvarial Hemangioma of the Temporal Bone

“…Histologically, hemangiomas are classified as cavernous and capillary hemangiomas. Most of the PICHs, including of the present case, are of the cavernous type, which is composed of a group of large, dilated blood vessels separated by fibrous tissue 3 …”

“…1,3 This typical characteristic is due to osteoclastic remodeling with trabecular bone following osteoblastic activity of the tumor. 3 In the present case, the ''wagon-wheel'' feature on the CT scan indicated the diagnosis of PICH. C-E).…”

“…Most of the PICHs, including of the present case, are of the cavernous type, which is composed of a group of large, dilated blood vessels separated by fibrous tissue. 3 Therapeutic options for PICH include total resection, embolization before surgery, and radiotherapy. [1][2][3] Total resection of the tumor is the best treatment for PICH.…”

“…3 Therapeutic options for PICH include total resection, embolization before surgery, and radiotherapy. [1][2][3] Total resection of the tumor is the best treatment for PICH. As PICH arises from vessels in the diploic space and receive additional blood supply from branches of the external carotid artery that originate inside the skull vault, preoperative embolization of these supply arteries is a good strategy to reduce the intraoperative blood loss.…”

“…The diagnosis of PICH is usually difficult, as the imaging finding is not specific, except for the appearance of ''wagonwheel,'' or ''sunburst'' pattern with striations radiating from the center on the CT scan. 1,3 This typical characteristic is due to osteoclastic remodeling with trabecular bone following osteoblastic activity of the tumor. 3 In the present case, the ''wagon-wheel'' feature on the CT scan indicated the diagnosis of PICH.…”