Haemangioma of the forehead: Radiographic diagnosis and definitive surgical treatment in a Japanese series

Calvarial hemangiomas: Series of 6 cases and review of literature

Calvarial haemangiomas are benign, vascular tumours of the skull involving parietal and frontal bones. Mostly these lesions remain asymptomatic, and present with cosmetic deformity, headache, uncommon neurological symptoms and reported as case reports and case series. The radiological appearance can range from sessile growing intradiploically to globular and the lesions may extend outwards or inwards after eroding the outer and inner tables of the skull. "Sunburst appearance" and "Wagon-wheel sign" are classical radiological findings but the lesions may present simply as a lytic expansile or even sclerotic calvarial mass. Because of varied clinical presentation and atypical radiological characteristics, the final diagnosis can be clinched by histology only. In selected cases where these lesions are not cosmetically acceptable, en bloc resection with tumour free margins followed by cranioplasty is the treatment of choice. Most reports of calvarial haemangiomas in literature are in the form of case reports.

Technical strategies for en bloc resection and immediate reconstruction in hemangioma of the frontal bone

Hemangioma of the skull is a benign solitary tumor, often found in the frontal or parietal area. A hemangioma lesion typically involves the outer table rather than the inner, but its complete removal at the diploe level is difficult. Full-thickness resection at the calvaria is often needed to ensure a free margin, but it will leave a bony defect that requires reconstruction. Although curettage and covering of the lesion with alloplastic material are a simple treatment option for hemangioma of the skull, it does not always prevent recurrence. Hence, complete resection is needed. As our technical strategies for reconstruction, we organize a split calvarial bone graft if a defect is near the frontal sinus and calcium phosphate cement if it is somewhat far from the sinus.