Report of a case of cavernous haemangioma of the cavernous sinus

Abstract

Cavernous haemangioma of the cavernous sinus is a rare vascular malformation. It's often confused with other parasellar masses. Here, we report a case of a female with a left parasellar mass which was misdiagnosed as schwannoma vs meningioma using CT and MRI. The patient was operated via the pterional approach but resection had been halted due to severe haemorrhage and only tumour biopsy could be obtained. The diagnosis of cavernous sinus haemangioma was established by histopathology and confirmed by subsequent digital subtraction angiography. The patient refused second surgery or adjuvant radiosurgery and the treatment strategy was observation and follow-up. Retrospectively, we included the key radiographic features of cavernous sinus haemangioma which would facilitate pre-operative diagnosis and avoid unforeseen operative complications. Diagnostic radiographic features include a well-defined mass in the cavernous sinus which shows isodense to slightly hyperdense attenuation on non-contrast CT scan with possible adjacent pressure bone remodelling. On MRI, it shows remarkable high T2 signal; intense homogenous enhancement or characteristic progressive contrast enhancement on sequential enhanced images. On digital subtraction angiography, it may demonstrate a vascular blush.

Early Response to Radiation Therapy without Surgical Intervention in a Giant Cavernous Sinus Hemangioma with Hydrocephalus: A Case Report

“…Compared with cavernous malformation (CM), CSH is neither in the brain parenchyma nor contains histological evidence of prior hemorrhage, thrombosis, or calcification. 1) Radiographically, CSH shows low intensity on T1WI, markedly high intensity on T2WI, high density on CT without signs of hemosiderin deposition, and uniform enhancement on contrasted T1 images, [7][8][9] whereas CM shows heterogenous intensity on T1WI and T2WI, with subtle or no gadolinium enhancement on T1, and is prominent on hemosiderin-sensitive sequences. 1,10) CSH angiography may demonstrate a "blush" appearance due to contrast accumulation in small feeding arteries, as in the current case, 8,9) whereas CM is angiographically occult.…”

“…1) Radiographically, CSH shows low intensity on T1WI, markedly high intensity on T2WI, high density on CT without signs of hemosiderin deposition, and uniform enhancement on contrasted T1 images, [7][8][9] whereas CM shows heterogenous intensity on T1WI and T2WI, with subtle or no gadolinium enhancement on T1, and is prominent on hemosiderin-sensitive sequences. 1,10) CSH angiography may demonstrate a "blush" appearance due to contrast accumulation in small feeding arteries, as in the current case, 8,9) whereas CM is angiographically occult. 1,10) Differential diagnosis includes meningioma, especially microcystic meningioma, which shows patently low intensity on T1WI and high intensity on T2WI, which may be similar to those of the present case.…”

Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview

“…In bone surgery, magnesium screws, plates, and sheets were employed to resurface ankylotic joints, resulting in the successful restoration of joint motion and the fixation of fractures [ 277 , 278 ]. In general surgery, magnesium devices, such as arrows and wires, were used to halt bleeding in parenchymatous organs and the treatment of hemangioma cavernous (venous malformation) [ 279 , 280 ].…”