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Albalawi SF, Hafiz BE, Turki A, Alturkustani M, Bakhsh SI, Sabbagh AJ. Intracranial Infantile Hemangioma: Highlighting a Rare Presentation With a Case Report and Literature Review. Cureus 2024; 16:e52341. [PMID: 38361697 PMCID: PMC10867379 DOI: 10.7759/cureus.52341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Infantile hemangioma is a common benign vascular tumor in children, but it is very unusual to be found intracranially. Our literature review identified 44 reported cases. Presentation can vary from asymptomatic to a life-threatening presentation that necessitates urgent surgical removal. There is no general consensus on management of these rare lesions and until recently, treatment was limited to surgery or pharmacological management with steroids, propranolol or interferon. We present a case of a four-week-old male infant with history of vomiting and increase in head circumference since birth. MRI of the brain revealed a large complex cyst occupying the right frontoparietal region, with round soft tissue component that is isointense on T1 and hyperintense on T2 weighted images. Complete surgical resection with evacuation of the cyst was achieved. Histopathology of the mass showed infantile hemangioma with positive CD31 on immunohistochemistry. The patient achieved an excellent outcome following surgical resection.
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Affiliation(s)
- Sultan F Albalawi
- Neurological Surgery, King Abdulaziz University Hospital, Jeddah, SAU
| | - Badr E Hafiz
- Neurosurgery, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
| | - Alanoud Turki
- Neurology, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Salwa I Bakhsh
- Pathology, King Abdulaziz University Hospital, Jeddah, SAU
| | - Abdulrahman J Sabbagh
- Training Administration, Saudi Commission for Health Specialties, Makkah, Jeddah and Taif, SAU
- Surgery, King Abdulaziz University Hospital, Jeddah, SAU
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Noureldine MHA, Rasras S, Safari H, Sabahi M, Jallo GI, Arjipour M. Spontaneous regression of multiple intracranial capillary hemangiomas in a newborn-long-term follow-up and literature review. Childs Nerv Syst 2021; 37:3225-3234. [PMID: 33481102 DOI: 10.1007/s00381-021-05053-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Intracranial capillary hemangiomas (ICHs) have a natural history and behavior that is very different from intracranial cavernous malformations. The literature is not consistent as to the best management strategy for ICHs. CASE DESCRIPTION Our patient is a 40-day-old male infant who presented with progressive increase in head circumference and multiple cutaneous capillary and ICHs. Obstructive hydrocephalus necessitated urgent cerebrospinal fluid (CSF) diversion, but no other surgical intervention was pursued due to the high risk-to-benefit ratio. All intracranial lesions spontaneously regressed by 11 years of age, albeit at a slower speed than the cutaneous lesions, with no functional or cognitive sequelae. We conducted a comprehensive literature review and provided a summary of all reported ICH cases. CONCLUSION Asymptomatic patients with ICHs are best approached with close follow-up and serial imaging studies as the potential for spontaneous regression is relatively high. Patients with isolated lesions or unclear diagnoses may benefit from a stereotactic biopsy, and surgical resection should be reserved for symptomatic lesions only.
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Affiliation(s)
| | - Saleh Rasras
- Department of Neurosurgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hosein Safari
- Department of Neurosurgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadmahdi Sabahi
- Neurosurgery Research Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.,Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - George I Jallo
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA
| | - Mahdi Arjipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Neurosurgery, Hamadan University of Medical Sciences, Shahid Fahmide St., Building No. 4, Hamadan, Iran.
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3
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Safe and Effective Treatment of Intracranial Infantile Hemangiomas with Beta-Blockers. Pediatr Rep 2021; 13:347-356. [PMID: 34287374 PMCID: PMC8293324 DOI: 10.3390/pediatric13030043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/07/2021] [Accepted: 06/29/2021] [Indexed: 11/25/2022] Open
Abstract
Infantile hemangiomas are common benign vascular tumors but are rarely found in an intracranial location. Our literature review identified 41 reported cases. There is no general consensus on management of these rare lesions and until recently, treatment was limited to surgery or pharmacological management with steroids or interferon. Although beta-blockers have been widely prescribed in the treatment of cutaneous infantile hemangiomas since 2008, their use in the treatment of intracranial infantile hemangiomas has been minimal. We present a case of infantile hemangioma affecting the right orbit, associated with intracranial extension, causing intermittent right facial nerve palsy. The patient achieved an excellent outcome following combined treatment with oral propranolol and topical timolol maleate 0.5%, with complete regression of the lesion by 4 months. We conclude that beta-blockers are a safe and effective treatment of intracranial infantile hemangiomas and can be employed as first-line management of these lesions.
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Santoro G, Piccirilli M, Chiarella V, Greco N, Berra LV, Santoro A. Intracranial capillary hemangiomas: literature review in pediatric and adult population. Neurosurg Rev 2020; 44:1977-1985. [PMID: 33079288 DOI: 10.1007/s10143-020-01419-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/17/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
Capillary hemangiomas (CHs) of the central nervous system represent a rare diagnosed pathology. CHs are benign vascular tumors whose most common manifestations are dermal and mucous and mainly occur during childhood or adolescence, while the involvement of the central nervous system can occur in a wider age range. We conducted a PubMed research on literature published until March 2020. We only enrolled cases with histological documented presence of intracranial CH. For every case collected, we analyzed age, sex, localization, neuroimaging studies performed, the presence of extracranial CHs, symptoms, neurological deficits, extent of surgical resection (biopsy, partial or gross total), adjunct treatment received (radiotherapy, chemotherapy, Trans-Arterial Embolization TAE), and outcome. Up to March 2020, the literature review identified 52 cases to which we added the case of our personal experience. The mean age was 26 with slightly female prevalence (28 F, 25 M). The most common presenting symptom was headache (21 cases, 40%). The surgical treatment consisted of biopsy in 7 cases (13%), partial resection in 10 cases (19%), gross total resection in 31 cases (58.5%), biopsy followed by total resection in 2 cases (3%), and partial resection followed by total resection in 1 case (1.5%), and the diagnosis was obtained from an autopsy sample in 1 case (1.5%). For symptomatic lesions, surgery is a valid option to obtain histological characterization, neurological improvement, and where possible a total resection. Stereotactic radiotherapy can be used if the lesion is not surgically approachable or as an adjuvant treatment in case of partial resection, having shown good results in terms of long-term disease control.
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Affiliation(s)
- Giorgio Santoro
- Department of Human Neurosciences, Neurosurgery, Sapienza University, Rome, Italy
| | - Manolo Piccirilli
- Department of Human Neurosciences, Neurosurgery, Sapienza University, Rome, Italy
| | - Vito Chiarella
- Department of Human Neurosciences, Neurosurgery, Sapienza University, Rome, Italy.
| | - Nicoletta Greco
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Aldo Moro University, Bari, Italy
| | | | - Antonio Santoro
- Department of Human Neurosciences, Neurosurgery, Sapienza University, Rome, Italy
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5
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Massman LJ, Conteh F, Cochran EJ, Zwagerman NT. Intracranial Capillary Hemangiomas: A Peripartum Presentation and Review of the Literature. World Neurosurg 2020; 145:220-228. [PMID: 32920159 DOI: 10.1016/j.wneu.2020.09.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intracranial capillary hemangiomas (ICHs) are rare vascular tumors composed of a bed of many narrow thin-walled vessels. Within the confines of the skull, these tumors can lead to serious neurologic deficits including cranial nerve dysfunction, mood/personality disturbances, and signs of intracranial mass effect. METHODS We report the case of a 23-year-old, 5-week postpartum woman with a history of progressive painful ophthalmalgia of the right eye presenting with rapid onset of ptosis, diplopia, and right-sided facial pain and hypesthesia. Imaging demonstrated a small extraaxial mass within the right cavernous sinus. She underwent 2 operations via an endoscopic endonasal approach for biopsy followed by complete resection. Histology showed a highly mitotic capillary hemangioma, which was negative for both estrogen and progesterone receptors. RESULTS We review cases of ICH reported in the literature and provide an updated summary of the presentation, diagnosis, and treatment of ICH. We then present a brief analysis of the reported cases with respect to age and sex. CONCLUSIONS We conclude that, in experienced hands, the endoscopic endonasal approach can be used to access the cavernous sinus for complete resection of ICHs of the cavernous sinus. We also suggest that further attention be paid to such cases in pregnant and peripartum women as these tumors may progress more quickly in this subpopulation.
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Affiliation(s)
| | - Fatu Conteh
- Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Elizabeth J Cochran
- Department of Pathology, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nathan T Zwagerman
- Department of Neurosurgery, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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Koga Y, Hamada S, Saito H, Akai T, Kuroda S. Intracranial, Intra-parenchymal Capillary Hemangioma - Case Report. NMC Case Rep J 2020; 7:43-46. [PMID: 32322449 PMCID: PMC7162812 DOI: 10.2176/nmccrj.cr.2019-0145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022] Open
Abstract
We report a very rare case of intracranial capillary hemangioma. This 15-year-old girl complained of pulsating headache in the temple area that aggravated with change of body positions. This headache usually lasted for 5 min and resolved without any treatment. Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) strongly suggested cavernous hemangioma in the right deep parietal lobe. She underwent complete resection of the tumor through right parietal craniotomy. Postoperative course was uneventful. Histologic examinations demonstrated a densely grown numerous capillary-like vascular structure with endothelial cells, hemosiderin deposition, and hemorrhage. Intracranial, intra-parenchymal capillary hemangioma is a very rare vascular tumor or tumor like lesions. Only four cases with intracranial, intra-parenchymal capillary hemangioma were reported previously. Differential diagnosis includes other vascular tumors such as cavernous hemangioma, but it is not so easy to differentiate capillary hemangioma from other lesions. Therefore, surgical excision and histologic diagnosis would be important to diagnose it if possible.
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Affiliation(s)
- Yuichiro Koga
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan
| | - Saori Hamada
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan
| | - Hisayasu Saito
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan
| | - Takuya Akai
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan
| | - Satoshi Kuroda
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan
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A unique case of benign intracranial hemangioma mimicking malignant transformation. Radiol Case Rep 2018; 13:1058-1062. [PMID: 30228843 PMCID: PMC6137388 DOI: 10.1016/j.radcr.2018.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/08/2018] [Indexed: 01/31/2023] Open
Abstract
Capillary hemangiomas are rare benign vascular lesions, commonly found on scalp, face, chest, or back of a neonate or infant. Hemangiomas of the central nervous system are very rare lesions. There are only a few cases of intracranial capillary hemangioma (ICH) arising in adults reported in the literature. We present a case of 59-year-old female with intermittent recurrent headache localized in the frontal area. Magnetic resonance imaging revealed left frontal extra-axial mass with peripheral enhancement. The patient underwent complete surgical resection of the tumor. Histopathology examination of the lesion revealed well defined vascular lesion composed of closely packed plump endothelial cells lining slit-like vascular channels containing scattered red blood cells. No evidence of infiltrative brain parenchyma was seen. Ki-67 proliferative index was low, less than 2%. The final diagnosis was confirmed to be ICH by histopathology and immunohistochemistry studies. The patient has remained healthy and free of disease 39 months since her initial surgery. ICH is a benign vascular lesion which rarely occurs in the central nervous system, particularly in the intracranial region. It can mimic malignant lesions on radiologic studies. Histopathology examination is the gold standard for diagnosis. If total resection is achieved, prognosis is generally good with no evidence of recurrence.
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8
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Lee JH, Jeon I, Kim SW. Intradural Extramedullary Capillary Hemangioma In the Upper Thoracic Spine with Simultaneous Extensive Arachnoiditis. KOREAN JOURNAL OF SPINE 2017; 14:57-60. [PMID: 28704911 PMCID: PMC5518430 DOI: 10.14245/kjs.2017.14.2.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/25/2017] [Accepted: 04/24/2017] [Indexed: 11/30/2022]
Abstract
Capillary hemangiomas are common benign vascular tumors on skin and soft tissues, but developing as an intradural and extramedullary (IDEM) tumor in spine is extremely rare. In this report, we present IDEM tumor compressing thoracic cord in T2–3 level with extensive arachnoiditis below the tumor level in a 60-year-old man. The lesion was removed and histological diagnosis was capillary hemangioma. Prompt diagnosis and resection are important to avoid neurological deterioration from acute hemorrhagic condition. Simultaneous arachnoiditis may be originated from old subarachnoid hemorrhage associated tumor before diagnosis, and we suggest it as a helpful diagnostic feature to suspect vascular tumors such as capillary hemangioma.
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Affiliation(s)
- Jae Ho Lee
- Department of Neurosurgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Ikchan Jeon
- Department of Neurosurgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang Woo Kim
- Department of Neurosurgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
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9
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Xia X, Zhang H, Gao H, Yang Y, Dai Y, Jiao Y, He J. Nearly asymptomatic intracranial capillary hemangiomas: A case report and literature review. Exp Ther Med 2017; 14:2007-2014. [PMID: 28962117 PMCID: PMC5609166 DOI: 10.3892/etm.2017.4780] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 05/11/2017] [Indexed: 11/06/2022] Open
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.
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Affiliation(s)
- Xiaoyu Xia
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, P.R. China
| | - Haoju Zhang
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, P.R. China
| | - Hongyan Gao
- Medical Administration Division, PLA Army General Hospital, Beijing 100700, P.R. China
| | - Yi Yang
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, P.R. China
| | - Yiwu Dai
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, P.R. China
| | - Yang Jiao
- Department of Stomatology, PLA Army General Hospital, Beijing 100700, P.R. China
| | - Jianghong He
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, P.R. China
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10
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Cavalheiro S, Campos HGDA, Silva da Costa MD. A case of giant fetal intracranial capillary hemangioma cured with propranolol. J Neurosurg Pediatr 2016; 17:711-6. [PMID: 26824594 DOI: 10.3171/2015.11.peds15469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fetal brain tumors are rare. This report describes a giant posterior fossa capillary hemangioma treated with 3 mg/kg/day of propranolol for 6 months. Total regression was confirmed at 1 year, and no additional tumors were observed during the subsequent 2 years. No side effects relating to the use of this drug were detected; thus, the authors believe that propranolol may be useful for treating all intracranial capillary hemangiomas.
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11
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Kang E, Friedman N, Mamoun I, Tamburro J, Golden A. Beta Blockade as Treatment for Intracranial Infantile Hemangioma: Case Report and Literature Review. Pediatr Neurol 2016; 59:13-7. [PMID: 27068061 DOI: 10.1016/j.pediatrneurol.2016.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intracranial infantile hemangiomas are extremely rare, with only 36 patients reported in literature. Treatment for intracranial infantile hemangiomas has been mostly limited to surgery, steroids, and interferon therapy. Propranolol, which is often used to treat cutaneous infantile hemangiomas, is not currently standard treatment for intracranial infantile hemangiomas. PATIENT DESCRIPTION We present a one-month old boy with an intracranial infantile hemangioma treated with propranolol. RESULTS This boy was being treated with oral propranolol for a supraclavicular infantile hemangioma. Subsequent brain magnetic resonance imaging (MRI) scan showed evidence of an associated intracranial infantile hemangioma in the right cerebellopontine angle. Repeat brain MRI scan after two months of propranolol treatment demonstrated a significant reduction in the size of the intracranial infantile hemangioma. CONCLUSIONS This is the first report of successful therapy of an intracranial infantile hemangioma with propranolol.
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Affiliation(s)
- Elise Kang
- School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Neil Friedman
- Center for Pediatric Neurology, Neurologic Institute and Cleveland Clinic Children's Hospital, Cleveland Clinic, Cleveland, Ohio
| | - Ihsan Mamoun
- Pediatric and Neuroimaging, Cleveland Clinic Imaging Institute, Cleveland, Ohio
| | - Joan Tamburro
- Department of Pediatric Dermatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Alex Golden
- Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland, Ohio.
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12
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Abstract
Two cases of intracranial capillary hemangiomas (ICHs) occurring in children are presented to highlight the surgical challenges encountered with these extremely rare lesions. The author describes their clinical presentation, preoperative imaging features, intraoperative findings, and operative management. The pertinent literature is reviewed. Recommendations for preoperative planning and intraoperative management are made based on the author's experience and the literature for when ICH is considered in the differential diagnosis and encountered intraoperatively.
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Affiliation(s)
- Paul A Grabb
- Department of Neurosurgery, Children's Mercy Hospital, Kansas City, Missouri; and University of Kansas School of Medicine, Kansas City, Kansas
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13
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Mirza B, Shi WY, Phadke R, Holton JL, Turner C, Plant GT, Brew S, Kitchen N, Zrinzo L. Strawberries on the Brain—Intracranial Capillary Hemangioma: Two Case Reports and Systematic Literature Review in Children and Adults. World Neurosurg 2013; 80:900.e13-21. [DOI: 10.1016/j.wneu.2012.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 10/10/2012] [Accepted: 12/07/2012] [Indexed: 12/27/2022]
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14
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Yeo KK, Puscasiu E, Keating RF, Rood BR. Durable response of intracranial cellular hemangioma to bevacizumab and temozolomide. J Neurosurg Pediatr 2013; 11:682-6. [PMID: 23540527 DOI: 10.3171/2013.2.peds12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cellular hemangioma is a subtype of hemangioma that is associated with cellular immaturity and the potential for recurrence. Intracranial location of these lesions is extremely rare, and definitive treatment often requires radical neurosurgical resection. The authors report a case of a 12-year-old boy with a subtemporal cellular hemangioma. He underwent gross-total resection of the tumor, but within 1.5 months the tumor recurred, necessitating a second resection. Because of its proximity to vascular structures, only subtotal resection was possible. Repeat MRI 1 month after the second surgery showed significant tumor recurrence. Given the tumor's demonstrated capacity for recurrence and its proximity to the vein of Labbé and sigmoid sinus, further resection was not indicated. In an effort to limit radiation therapy for this young patient, treatment with bevacizumab and temozolomide was chosen and achieved a complete response that has proven durable for 36 months after cessation of therapy. This is the first report of the successful use of chemotherapy to treat an intracranial hemangioma, a rare condition with limited therapeutic options.
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Affiliation(s)
- Kee Kiat Yeo
- Department of Pediatrics, Children’s National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA
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15
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Morace R, Marongiu A, Vangelista T, Galasso V, Colonnese C, Giangaspero F, Innocenzi G, Esposito V, Cantore G. Intracranial Capillary Hemangioma: A Description of Four Cases. World Neurosurg 2012; 78:191.E15-21. [DOI: 10.1016/j.wneu.2011.09.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 05/30/2011] [Accepted: 09/04/2011] [Indexed: 12/19/2022]
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16
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Phi JH, Kim SK, Cho A, Kim DG, Paek SH, Park SH, Wang KC. Intracranial capillary hemangioma: extra-axial tumorous lesions closely mimicking meningioma. J Neurooncol 2012; 109:177-85. [DOI: 10.1007/s11060-012-0884-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 04/16/2012] [Indexed: 12/26/2022]
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17
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John SG, Pillai U, Lacasse A. Intracranial capillary hemangioma mimicking a dissociative disorder. Clin Pract 2012; 2:e35. [PMID: 24765434 PMCID: PMC3981297 DOI: 10.4081/cp.2012.e35] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 01/31/2012] [Accepted: 02/09/2012] [Indexed: 01/19/2023] Open
Abstract
Capillary hemangiomas, hamartomatous proliferation of vascular endothelial cells, are rare in the central nervous system (CNS). Intracranial capillary hemangiomas presenting with reversible behavioral abnormalities and focal neurological deficits have rarely been reported. We report a case of CNS capillary hemangioma presenting with transient focal neurological deficits and behavioral abnormalities mimicking Ganser's syndrome. Patient underwent total excision of the vascular malformation, resulting in complete resolution of his symptoms.
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Affiliation(s)
- Santosh G John
- Department of Internal Medicine, St. Marys health Center, St. Louis, Missouri, USA
| | - Unnikrishnan Pillai
- Department of Internal Medicine, St. Marys health Center, St. Louis, Missouri, USA
| | - Alexander Lacasse
- Department of Internal Medicine, St. Marys health Center, St. Louis, Missouri, USA
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18
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Philpott C, Wray A, MacGregor D, Coleman L. Dural infantile hemangioma masquerading as a skull vault lesion. AJNR Am J Neuroradiol 2011; 33:E85-7. [PMID: 22116108 DOI: 10.3174/ajnr.a2752] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We describe a case of intracranial dural IH initially diagnosed as a primary skull vault lesion hemangioma due to associated focal hyperostosis. Histopathologic examination of the dural component confirmed IH. The case is discussed in the context of IH within the neural axis.
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Affiliation(s)
- C Philpott
- Department of Radiology, Royal Children’s Hospital Melbourne, Australia.
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19
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Mori N, Yanagihara T, Nagasaka H, Katsuki N, Haba R, Nishiyama Y, Tamiya T, Itoh S, Hata T. Antenatal ultrasonographic features of fetal capillary hemangioma in the posterior fossa. J Obstet Gynaecol Res 2010; 37:79-83. [PMID: 21040213 DOI: 10.1111/j.1447-0756.2010.01322.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A capillary hemangioma with hydrocephalus in the posterior fossa of a fetus was detected on ultrasonography at 38 weeks and 4 days of gestation. A well-defined, round tumor with a mixed pattern occupied the posterior fossa, and the normal cerebellum was significantly compressed by this tumor. No other anomaly was detected. Delivery was induced because of rapidly progressive hydrocephalus, and an otherwise healthy female infant weighing 2800 g was delivered vaginally at 39 weeks and 4 days of gestation. Histologic examination of the lesion through biopsy demonstrated capillary hemangioma. The tumor spontaneously decreased in size, and disappeared six months later. The child is now 2 years of age, and is developing normally.
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Affiliation(s)
- Nobuhiro Mori
- Department of Perinatology and Gynecology, Kagawa University School of Medicine, Ikenobe, Miki, Kagawa, Japan
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Daenekindt T, Weyns F, Kho KH, Peuskens D, Engelborghs K, Wuyts J. Giant intracranial capillary hemangioma associated with enlarged head circumference in a newborn. J Neurosurg Pediatr 2008; 1:488-92. [PMID: 18518703 DOI: 10.3171/ped/2008/1/6/488] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The authors describe the case of a patient with an intracranial capillary hemangioma, and they review the recent literature on intracranial capillary hemangiomas with special attention to their differential diagnosis and management. The only sign in this 7-week-old boy was head enlargement. There were no neurological deficits, and imaging revealed a large intracranial lesion in the right temporal fossa. The results of biopsy confirmed the diagnosis, and, after endovascular embolization, the entire lesion was resected. The incidence of intracranial capillary hemangioma is very low but may be underestimated. In the present case, the size of the tumor prompted surgical treatment. The natural behavior of extracranial capillary hemangiomas, however, suggests that a conservative approach with follow-up and steroid therapy may also be considered.
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Affiliation(s)
- Thomas Daenekindt
- Department of Neurosurgery, Ziekenhuizen Oost-Limburg, Genk, University Hospitals Leuven, Belgium.
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