Intravascular papillary endothelial hyperplasia at the superior orbital fissure: report of a case successfully treated with gamma knife radiosurgery

Intracerebral Masson's Tumor—Slow-Filling Vascular Lesion Demonstrated by Indocyanine Green Video Angiography

“…Surgical excision however, may be the only option and complete resection is often curative 17 , unlike subtotal resection which is associated with recurrence 19 . Where complete resection is not possible, adjuvant Gamma knife radiosurgery should be considered as this has been shown to be an effective 20 . However, one must proceed with caution as radiosurgery has been suggested to be one of the predisposing factors associated with this lesion 21 .…”

Incidental Papillary Endothelial Hyperplasia of the Cavernous Sinus: Case Report and Review of the Literature

“…[14]While some studies do not report a sex predilection, others have found that females, predominantly in their forties, are more commonly affected than men. [21]Three settings of the disease have been described as follows:Type I (primary or pure) IPEH develops within a histologically normal yet dilated vessel, which is usually a vein, although arteries may rarely be involved. Type II (mixed IPEH) occurs in preexisting vascular lesions, such as, hemangiomas, venous lakes, thrombosed aneurysms, arteriovenous malformations, pyogenic granulomas, and lymphangiomas.…”

“…IPEH appears as a highly vascular isointense or mildly hyperintense mass on T1-weighted MRI and hyperintense on T2 sequences.T1-weighted MRIwith gadolinium reveals an intensely enhancing homogenous mass. [8,21] Angiographic findings are variable and range from angiographically occult to a vascular blush. [18,23] The clinical presentation of IPEH is variable and dependent upon the location of the lesion.…”

“…Ohshima et al demonstrated a reduction in lesion size and improvement in symptoms with GKR at two-year follow-up for residual IPEH of the middle cranial fossa. [21]Chemotherapy has been recommended by some authors, however, there is no sufficient evidence currently available to confirm benefit. [8] Our case is unique due to the co-occurrence of a prolactinoma and incidentalcavernous sinus IPEH.Despite the close proximity between the lesions, they represent two distinct and unrelated pathologies.…”

“…[2,5,6,14]IPEH occurs in different settings and has a female predisposition (M:F; 7:1) and often develops in thesuperficial soft tissues of the face and fingers. [7,21] Intracranial IPEH israre, and may occur as an extra-axial or intraparenchymal mass. [8,15] Progressive lesional growth results in mass effect on adjacent structures leading to various neurologic deficits.…”