Intraosseous cavernous hemangioma: presentation of a clinical case

Abstract

Background: Cavernous hemangiomas are benign tumors that exceptionally affect the cranial bones. The first description of this type of tumor was in 1845 by Toynbee. A review of the literature reveals less than 100 published cases and a growing trend every year. Total surgical excision is the treatment of choice, and the prognosis after complete excision is excellent, with a recurrence usually rare. Case presentation: We present the case of a 57-year-old patient with a painless tumor of the left frontal bone, of slow growth and osteolytic characteristics from the neuro-radiological point of view. The lesion was excised en bloc by craniectomy, followed by cranioplasty. The anatomopathological diagnosis was intraosseous cavernous hemangioma. Conclusions: Despite its low frequency, the diagnosis of intraosseous cavernous hemangioma should be considered in the presence of a slow-growing cranial tumor, with solid and painless characteristics, and its osteolytic nature confirmed by radiology. The treatment of choice consists in the complete resection of the lesion.

Surgical Management of a Massive Frontal Bone Hemangioma: Case Report

“…They present as firm, solitary masses that slowly progress over months or years. 1 2 4 6 7 8 9 10 11 13 15 16 19 20 25 28 33 34 Intracranial extension of a calvarial based intraosseous hemangioma is an infrequent occurrence. 1 2 3 5 13 14 19 20 Few prior reports have noted expansion of these lesions beyond the dural plane.…”

“…1 2 4 6 7 8 9 10 11 13 15 16 19 20 25 28 33 34 Intracranial extension of a calvarial based intraosseous hemangioma is an infrequent occurrence. 1 2 3 5 13 14 19 20 Few prior reports have noted expansion of these lesions beyond the dural plane. 2 8 11 13 24 Park et al and Khanam et al describe patients with intracranial expansion loosely attached to the dura, while Peterson et al describe a patient with extension through the dura and anastomoses with the thin-walled vessels on the surface of the cerebellum.…”

“…The treatment of choice is en bloc resection with 5 to 10 mm wide bone margin for the primary goals of limiting painful progression, improving cosmesis, and avoiding potential complications such as hemorrhage. 1 2 4 5 7 8 9 11 12 13 14 17 19 20 25 34 35 Utilization of preoperative embolization can be considered to aid surgical resection by decreasing intraoperative blood loss. 7 10 20 25…”

“…1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 These lesions represent 0.2% of primary cranial bone tumors and predominantly present as solitary lesions in the frontal or parietal bone. 1 2 3 4 5 7 8 9 10 12 13 14 15 16 17 19 20 21 22 23 24 25 26 27 28 29 30 31 32 They often involve the outer table and diploic space, while sparing the inner table, and are treated with en bloc surgical resection and cranioplasty. 2 13 14 20 Few reports have described intraosseous cavernous hemangiomas extending beyond the inner table or with substantial involvement of the bifrontal calvarium.…”

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“…They present as firm, solitary masses that slowly progress over months or years. 1,2,4,[6][7][8][9][10][11]13,15,16,19,20,25,28,33,34 Intracranial extension of a calvarial based intraosseous hemangioma is an infrequent occurrence. [1][2][3]5,13,14,19,20 Few prior reports have noted expansion of these lesions beyond the dural plane.…”