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Alexiou GA, Lampros M, Gavra MM, Vlachos N, Ydreos J, Boviatsis EJ. Primary Intraosseous Cavernous Hemangioma of the Cranium: A Systematic Review of the Literature. World Neurosurg 2022; 164:323-329. [PMID: 35654328 DOI: 10.1016/j.wneu.2022.05.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Primary intraosseous cavernous hemangioma (PICH) is a rare, benign tumor of vascular origin, typically arising in the vertebral body. Its presence in the skull is exceedingly rare, with only a few cases being reported worldwide. We carried out the first systematic review of the literature, covering the epidemiology, clinical and imaging features, management, and prognosis of cranial PICH. The literature search revealed 51 studies with 77 patients; the mean age of the patients was 32.7 years with a female predominance of 1.4:1. The majority of cranial PICHs were located in the calvarium, primarily in the frontal and parietal regions, with only a few located in the skull base. The most common initial clinical manifestation was local growth or swelling, followed by a headache. Radiographically, PICHs represented osteolytic, intradiploic masses, which in many cases displayed trabeculations, leading to the so-called "honeycomb" or "starburst" pattern. After contrast administration, PICHs typically enhance. Tumor removal, with craniectomy or en bloc resection and subsequent skull reconstruction, was selected for calvarial PICHs, whereas a transsphenoidal approach, with only partial resection, was applied for clival/sella PICHs. Preoperative embolization, aiming to minimize intraoperative blood loss, was performed in the case of large tumors. At a mean follow-up of 39 months, no patient experienced tumor recurrence, even after subtotal resection. Owing to the benign nature of the tumor, maximal safe resection is recommended as the treatment of choice for patients with cranial PICH.
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Affiliation(s)
- George A Alexiou
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece.
| | - Marios Lampros
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - Maria M Gavra
- Department of CT and MRI Imaging, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Nikolaos Vlachos
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
| | - John Ydreos
- Department of Neurosurgery, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios J Boviatsis
- Department of Neurosurgery, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Sáenz AA, Porto NF, Sánchez MP. Intraosseous cavernous hemangioma: presentation of a clinical case. EGYPTIAN JOURNAL OF NEUROSURGERY 2018. [DOI: 10.1186/s41984-018-0018-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Elif B, Derya Y, Gulperi K, Sevgi B. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report. J Clin Exp Dent 2017; 9:e153-e156. [PMID: 28149481 PMCID: PMC5268109 DOI: 10.4317/jced.52864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/02/2016] [Indexed: 11/07/2022] Open
Abstract
Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed.
Key words:Hemangioma, intraosseous, mandible, cavernous, cbct.
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Affiliation(s)
- Bilgir Elif
- PhD, Research Assistant; Suleyman Demirel University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Isparta, Turkey
| | - Yildirim Derya
- DDS, PhD, Associated Professor; Suleyman Demirel University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Isparta, Turkey
| | - Kocer Gulperi
- DDS, PhD, Associated Professor; Suleyman Demirel University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Isparta, Turkey
| | - Bozova Sevgi
- MD, Specialist Doctor of Medicine; Ministry of Health Turkish Public Hospitals Institution Association of Antalya Public Hospitals Serik State Hospital, Department of Pathology, Antalya/Turkey
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4
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Moumine M, Steve M, Nassih M. [A tumour of tail of the eyebrow]. ACTA ACUST UNITED AC 2013; 114:e13-5. [PMID: 24054863 DOI: 10.1016/j.revsto.2013.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 03/27/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
Affiliation(s)
- M Moumine
- Service de stomatologie et chirurgie maxillo-faciale, hôpital militaire Moulay-Ismail, BP 50000, Meknès, Maroc.
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Ebrahimi A, Etemadifar M, Ardestani PM, Maghzi AH, Jaffe S, Nejadnik H. Cavernous angioma: a clinical study of 35 cases with review of the literature. Neurol Res 2013; 31:785-93. [DOI: 10.1179/016164109x12445505689445] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Rumana M, Khursheed N, Farhat M, Othman S, Masood L. Congenital intraosseous cavernous hemangioma of the skull: an unusual case. Pediatr Neurosurg 2013; 49:229-31. [PMID: 25060919 DOI: 10.1159/000363328] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 04/30/2014] [Indexed: 11/19/2022]
Abstract
Intraosseous hemangiomas are benign vascular malformations mostly seen in the spine. They rarely occur in the skull. The usual age-group involved is the 2nd to 4th decades, and females outnumber males. We hereby report a rare case of congenital intraosseous cavernous hemangioma of the skull bone in a male infant. The patient underwent total excision of the lesion.
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Affiliation(s)
- Makhdoomi Rumana
- Department of Pathology, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
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Haeren RHL, Dings J, Hoeberigs MC, Riedl RG, Rijkers K. Posttraumatic skull hemangioma: case report. J Neurosurg 2012; 117:1082-8. [PMID: 22998057 DOI: 10.3171/2012.8.jns112141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intraosseous cavernous hemangiomas of the skull are rare lesions for which the origin is unclear. The authors present a case in which there was a radiologically documented history of trauma preceding the development of a hemangioma in the frontal bone. In a review of the literature the authors found 83 cases of skull hemangiomas, and 43% of the lesions were located in the frontal bone. In 25% of these lesions, previous trauma was reported anamnestically. The present case and radiological findings related to it suggest a causal relationship between trauma and the development of intraosseous hemangioma.
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Affiliation(s)
- Roel H L Haeren
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
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Zhong W, Li G, Huang S, Chen H, You C. Intradiploic hemangioma with repeated hemorrhage in a child with hemophilia. J Neurosurg Pediatr 2012; 10:56-9. [PMID: 22702325 DOI: 10.3171/2012.3.peds11423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Intraosseous hemangioma is an uncommon benign vascular tumor, which is most frequently found in middle-aged female patients. The clinical course is usually insidious and the outcome excellent after total resection. The authors report a case of a calvarial hemangioma in a child with hemophilia who experienced a catastrophic postoperative hematoma and discuss the mechanism, clinical features, and treatment of this condition.
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Affiliation(s)
- Weiying Zhong
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Eap C, Litre CF, Jazeron JF, Theret E, Duntze J, Patey M, Rousseaux P. [Intradiploic cavernous hemangioma of the calvaria: case report and review of the literature]. Neurochirurgie 2010; 57:42-5. [PMID: 20870256 DOI: 10.1016/j.neuchi.2010.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 07/09/2010] [Indexed: 11/15/2022]
Abstract
We report the case of a 31-year-old patient who had had frontal cephalalgias for several years. CT and MRI anatomical imaging objectified a frontal osteolytic tumor respecting the osseous external table but compressing the superior sagittal sinus. Total en bloc resection of the tumor associated with titan cranioplasty was performed. The postoperative course was uneventful. Three months after surgery the patient no longer reported headache. The anatomical and pathological results concluded in intradiploic cavernous hemangioma. We discuss this case and others described in the literature.
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Affiliation(s)
- C Eap
- Service de neurochirurgie, hôpital Maison-Blanche, CHU de Reims, 45 rue Cognacq-Jay, Reims, France.
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Vega A, De Obieta E, Aguado G, Esqueda M, Ruíz S, Ramirez E, Pérez J. Hemangioma cavernoso multifocal en cráneo. Revisión de un caso. Neurocirugia (Astur) 2010. [DOI: 10.1016/s1130-1473(10)70101-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Sasagawa Y, Akai T, Yamamoto K, Masuoka T, Itou S, Oohashi M, Iizuka H. Multiple cavernous hemangiomas of the skull associated with hepatic lesions. Case report. Neurol Med Chir (Tokyo) 2009; 49:162-6. [PMID: 19398861 DOI: 10.2176/nmc.49.162] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 55-year-old woman presented with multiple calvarial cavernous hemangiomas manifesting as right frontal swelling. Craniography and computed tomography showed an osteolytic lesion. Magnetic resonance imaging demonstrated multiple intraosseous lesions, and radioisotope bone scintigraphy identified even more numerous lesions. Total resection of the right frontal lesion and cranioplasty was performed. Histological examination confirmed the lesion as a cavernous hemangioma. Computed tomography of the abdomen revealed multiple hepatic lesions, which might be cavernous hemangiomas. Cavernous hemangioma is a rare bony tumor that should be considered in the differential diagnosis of skull tumors. A patient with multiple cavernous hemangiomas should undergo systemic examination to look for latent lesions, and regular follow-up examinations.
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Affiliation(s)
- Yasuo Sasagawa
- Department of Neurosurgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama, Japan.
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Vural M, Acikalin MF, Adapinar B, Atasoy MA. Congenital cavernous hemangioma of the calvaria. Case report. J Neurosurg Pediatr 2009; 3:41-5. [PMID: 19119903 DOI: 10.3171/2008.10.peds08161] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors present the case of a 6-month-old infant with a cavernous hemangioma of the parietal bone and discuss the radiological, operative, and pathological features and differential diagnosis of these extremely rare lesions in infants. Only 1 case of an infant with a calvarial cavernous hemangioma without intracranial invasion has previously been reported, and that case involved a 4 month old. Although a cavernous hemangioma of the calvaria is extremely rare in the newborn, this condition should be included in the differential diagnosis of calvarial lesions. During surgical treatment of calvarial cavernous hemangiomas, utmost attention should be paid to avoid blood loss, which could be fatal in infants.
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Affiliation(s)
- Murat Vural
- Department of Neurosurgery, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
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Naama O, Gazzaz M, Akhaddar A, Belhachmi A, Asri A, Elmostarchid B, Elbouzidi A, Kadiri B, Boucetta M. Cavernous hemangioma of the skull: 3 case reports. SURGICAL NEUROLOGY 2008; 70:654-659. [PMID: 18207223 DOI: 10.1016/j.surneu.2007.05.052] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Accepted: 05/18/2007] [Indexed: 05/25/2023]
Abstract
BACKGROUND Intraosseous cavernous hemangiomas of the bone are uncommon tumors, accounting for 0.7% to 1% of all bone neoplasms. The vertebral column is most often affected, followed by the skull. Calvarial cavernous hemangioma is rare, comprising about 0.2% of all benign neoplasms of the skull. CASES REPORTS We describe 3 patients with calvarial hemangiomas that were localized frontally (2 cases) and parietally. The diameter ranged from 2 to 3 cm. They presented with slowly growing mass, hard to pressure, with freely mobile skin above the cavernoma sites. Cranial CT scan showed osteolytic lesion with erosion of the tabula externa. Magnetic resonance imaging performed in one patient showed hypointense lesion on T1-weighted image and hyperintense on T2-weighted image. Resection and postoperative course were uneventful. Pathological examination revealed a cavernous hemangioma of the diploe. CONCLUSION Skull cavernous hemangiomas are rare benign tumors. The preferred treatment is complete tumor removal with normal bony margins. Sometimes, the classic radiographic appearances are not evident. Consequently, the diagnosis is most often made during surgical resection.
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Affiliation(s)
- Okacha Naama
- Department of Neurosurgery, Mohammed V Military Hospital, Rabat 56987, Morocco.
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