Nearly asymptomatic intracranial capillary hemangiomas: A case report and literature review

Abstract

The present study reported a nearly asymptomatic case of intracranial capillary hemangioma (ICHs), which are rare benign vascular tumors or tumor-like lesions. A 33-year-old female came to the hospital with a complaint of a slight but recurring morning headache concentrated in the left posterior occipital area. These headaches spontaneously resolved without any treatment. Computed tomography and magnetic resonance imaging revealed a mass inside the left occipital lobe. The patient refused to undergo conservative observation at home and insisted on radical therapy. Prior to surgery, an atypical meningioma or astrocytoma was suspected. A navigation-guided brain-mass resection was performed under general anesthesia and a solid mass closely associated with the tentorium cerebelli was completely resected. Histopathological analysis confirmed diagnosis of an ICH. The patient recovered well and experienced no major neurological defects, apart from an issue with the right visual field. The present study also conducted a retrospective literature review of papers published in English describing cases of intracranial capillary hemangiomas. A PubMed search identified 19 articles comprising 29 cases. The clinical symptoms of ICH are diverse and all reported cases in the literature were symptomatic. Previous studies demonstrated that diagnoses of intracranial capillary hemangioma are usually made during surgical resection by histopathological examination. Treatment for ICH remains empirical and surgery is the most common method of treatment. Patient prognosis is generally good-the majority of patients achieve long-term, event- and progression-free survival.

A unique case of benign intracranial hemangioma mimicking malignant transformation

“…Majority of ICH was diagnosed in infants and young adults with the age range from 2 weeks to 69 years old. These cases were seen in 14 male and 15 female patients [2] . ICH can arise in the cerebral lobe [6] , sagittal sinus [7] , cerebellum [6] , sellar region [8] , cavernous sinus [9] , fourth ventricles [10] , and anterior choroidal artery [11] .…”

“…CHs are seen in 1–2.6% of live births [2] . These tumors demonstrate female predominance, and can undergo hormonal response changes.…”

“…ICH can arise in the cerebral lobe [6] , sagittal sinus [7] , cerebellum [6] , sellar region [8] , cavernous sinus [9] , fourth ventricles [10] , and anterior choroidal artery [11] . Clinical signs and symptoms are variable and depend on lesion location, ranging from asymptomatic to headache, seizure, and cranial nerve palsy [2] . Radiological differential diagnoses in most of the reported cases were meningioma, astrocytoma, and any glial tumors with high-grade features.…”

“…Neonates and infants are the most affected age group. Ten to twelve percent shows tendency to grow within the first year of life [2] . Hemangioma can rarely grow in adults, with a slight female predominance, which undergoes remarkable size change due to pregnancy and hormonal cycles' response [3] .…”

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.…”