Giant Congenital Capillary Hemangioma of Pericranium

Abstract

The authors report a newborn male infant with a giant congenital capillary hemangioma of the pericranium. An elastic mass, measuring 6.5 x 6.9 x 3.9 cm, was located in the parieto-occipital region. Neurological examination revealed no abnormality. Angiographically, the tumor was fed symmetrically by the bilateral superficial temporal, occipital, and middle meningeal arteries. At surgery, the encapsulated tumor appeared to have arisen from the periosteum and was removed completely. Histological diagnosis was capillary hemangioma. Capillary hemangioma is a common benign tumor in infancy and usually present as a strawberry mark or port-wine stain. However, when the tumors seat relatively deeply as in the present case, they produce little or no discoloration in the overlying skin. Angiography is then useful to differentiate capillary hemangioma from other lesions and to choose an appropriate treatment.

Giant Hemangioma Presenting as a Scalp Mass Leading to a Craniofacial Deformity

“…Clinically hemangiomas may be superficial, deep (subcutaneous) or mixed [2] and approximately 80% of them appear as single and sporadic lesions during the postnatal period [1,2]. In most cases they are characterized by a strawberry mark or port-wine stain [7]. Only a small percentage of tumors are installed in the subcutaneous tissue [7], and it may or may not be a slight bluish tone on the skin [2].…”

“…In most cases they are characterized by a strawberry mark or port-wine stain [7]. Only a small percentage of tumors are installed in the subcutaneous tissue [7], and it may or may not be a slight bluish tone on the skin [2].…”

“…In about 70% of cases, after this stage, there is a growth arrest followed by a regression phase [2,4] that can last up to 10-12 years of age [1,4]; antiangiogenic factors (tissue inhibitor of metalloproteinase, mast cells, and scavenger macrophage) are involved with this regression [1]. In some cases, these lesions do not regress and they continue to grow and reach large dimensions [3][4][5][6][7][8][9][10][11]. Cases of giant hemangiomas forming masses that deform the scalp as the case reported here have rarely been reported in the literature [4][5][6][7][8][9][10][11], especially in adults [4].…”

“…Most lesions tend to regress by 10 years of age [1,2] and, in some cases, tumors can achieve large dimensions [3][4][5][6][7][8][9][10][11]. There is no clear definition about what size a lesion should achieve to be regarded as a giant hemangioma [6,7].…”

“…There is no clear definition about what size a lesion should achieve to be regarded as a giant hemangioma [6,7]. Colebatch et al [11] described the giant hemangioma as a tumor with a diameter of at least 5-6 cm.…”