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Park DJ, Hori YS, Nernekli K, Persad AR, Tayag A, Ustrzynski L, Emrich SC, Hancock SL, Chang SD. Stereotactic radiosurgery for facial nerve hemangioma: Case report and systematic review. J Clin Neurosci 2024; 126:21-25. [PMID: 38823231 DOI: 10.1016/j.jocn.2024.05.023] [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: 03/24/2024] [Revised: 05/04/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Facial nerve hemangiomas (FNHs) are rare tumors that primarily occur near the geniculate ganglion in the temporal bone. Despite their rarity, they can cause significant facial nerve dysfunction. The optimal management approach for FNHs remains uncertain, with surgery being the mainstay but subject to debate regarding the extent of resection and preservation of the facial nerve. METHODS Systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We queried the PubMed/Medline (accessed on 5 March 2024) electronic database using combinations of the following search terms and words text: "geniculate ganglion hemangioma", "ganglional hemangioma", "hemangioma of the facial nerve", "facial hemangioma", and "intratemporal hemangioma". RESULTS We identified a total of 30 literatures (321 patients). The most common site involved for the facial nerve hemangioma was the geniculate ganglion area followed by internal auditory canal, tympanic segment, labyrinthine segment and mastoid involvement. All patients were treated with conservative management or surgery. We report a 48-year-old female patient with HB grade 2 facial palsy and hemifacial spasm underwent SRS using Cyberknife technology. The treatment targeted the FNH in the left internal acoustic canal near the geniculate ganglion. Six months post-treatment, clinical improvement was evident, and lesion control was confirmed in a follow-up brain MRI. CONCLUSION The rarity of FNHs contributes to the lack of consensus on optimal management. This illustrative case demonstrates the feasibility of SRS as a standalone treatment for FNHs.
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Affiliation(s)
- David J Park
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Yusuke S Hori
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Kerem Nernekli
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Amit R Persad
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Armine Tayag
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Louisa Ustrzynski
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Sara C Emrich
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Steven L Hancock
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Steven D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, United States.
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Giotta Lucifero A, Luzzi S, Rabski J, Meredith D, Kadri PADS, Al-Mefty O. Surgical management of symptomatic hemangioma of the geniculate ganglion: fascicular-sparing resection or grafting? Neurosurg Rev 2023; 46:120. [PMID: 37184718 PMCID: PMC10185618 DOI: 10.1007/s10143-023-02029-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/18/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Abstract
Geniculate ganglion hemangioma (GGH) is rarely presented in the neurosurgical literature. It extends extradurally on the middle fossa floor and displaces the intratemporal part of the facial nerve. Surgical treatment is advisable at early symptoms. Proposed techniques include fascicular-sparing resection or nerve interruption with grafting. No definitive conclusions exist about the superiority of a certain technique in preserving facial nerve integrity and function. Through the description of a surgically managed symptomatic GGH, we herein discuss literature data about the surgical results of fascicular-sparing resection versus grafting. A PRISMA-based literature search was performed on the PubMed database. Only articles in English and published since 1990 were selected and furtherly filtered based on the best relevance. Statistical comparisons were performed with ANOVA. One hundred sixteen GGHs were collected, 56 were treated by fascicular-sparing resection, and 60 were treated by grafting. The facial function was improved, or unchanged, in 53 patients of the fascicular-sparing group and 30 patients of the grafting one. Sixty-five patients achieved a good (House-Brackmann (HB) grade III) postoperative facial outcome, of which 47 and 18 belonged to the fascicular-sparing and grafting group, respectively. Greater efficacy of the fascicular-sparing technique in the achievement of a better facial outcome was found (p = 0.0014; p = 0.0022). A surgical resection at the earliest symptoms is critical to preserve the facial nerve function in GGHs. Fascicular-sparing resection should be pursued in symptomatic cases with residual facial function (I-III HB). Conversely, grafting has a rationale for higher HB grades (V-VI). Broader studies are required to confirm these findings and turn them into new therapeutic perspectives.
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Affiliation(s)
- Alice Giotta Lucifero
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Neurosurgery Unit, University of Pavia, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sabino Luzzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Neurosurgery Unit, University of Pavia, Pavia, Italy.
- Department of Surgical Sciences, Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Jessica Rabski
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David Meredith
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Paulo Abdo do Seixo Kadri
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Medical School, Federal University of Mato Grosso Do Sul, Mato Grosso Do Sul, Campo Grande, Brazil
| | - Ossama Al-Mefty
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Longoni V, Scagnelli P, Tirelli G, Achilli VP. A rare case of endolymphatic sac hemangioma in a patient alleged to have Ménière's disease. Braz J Otorhinolaryngol 2020; 87:370-373. [PMID: 33303417 PMCID: PMC9422392 DOI: 10.1016/j.bjorl.2020.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/20/2020] [Indexed: 01/02/2023] Open
Affiliation(s)
- Valentina Longoni
- Azienda Sanitaria Universitaria Giuliano Isontina, Head and Neck Department, ENT Clinic, Trieste, Italy; Ospedale Maggiore, ENT Department, Lodi, Italy.
| | | | - Giancarlo Tirelli
- Azienda Sanitaria Universitaria Giuliano Isontina, Head and Neck Department, ENT Clinic, Trieste, Italy
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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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Abstract
INTRODUCTION Haemangiomas of the temporal bone are rare tumours and haemangiomas involving the middle ear are even rarer. The exceptional nature of these lesions makes their management particularly complicated. CASE REPORT The authors report the case of a 16-year-old girl, who presented with an osteolytic lesion of the left petrous temporal bone that proved to be a haemangioma with extension to the middle ear, causing conductive hearing loss. DISCUSSION Surgical biopsy is essential to establish the diagnosis of haemangioma because imaging alone only rarely provides a definitive diagnosis. Surgery is the reference treatment to prevent recurrence. Arteriography is an essential part of the preoperative assessment in order to limit the risk of bleeding.
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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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Wang C, Zhang D, Wang S, Zhang Y, Wang R, Zhao J. Intraosseous cavernous malformations of the skull: clinical characteristics and long-term surgical outcomes. Neurosurg Rev 2018; 43:231-239. [DOI: 10.1007/s10143-018-1042-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/04/2018] [Accepted: 10/10/2018] [Indexed: 11/25/2022]
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Pediatric cranial intraosseous hemangiomas: a review. Neurosurg Rev 2016; 41:109-117. [DOI: 10.1007/s10143-016-0779-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/01/2016] [Accepted: 08/15/2016] [Indexed: 10/21/2022]
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Abstract
A 59-year-old man presented with a slowly enlarging mass in the lateral orbital rim of the left eye for 1 year. He also reported a history of crania defect in the left front bone (6 years earlier) which was confirmed on the former computed tomographic (CT) scan. On examination, the solid mass lesion located in the left frontal extends to the lateral orbital rim of the left eye. CT scan showed a mass with poorly defined margins, which invaded the neighboring tissue and nearly damaged the bone, and located on the exact site of the preceding crania defect. Complete resection was performed, and the clinical diagnosis of cavernous hemangioma was confirmed on histopathologic examination. Skull cavernous hemangiomas are rare tumors for which the origin is not yet clear. We report a case in which the intraosseous hemangiomas developed at the same site of the preceding crania defect.
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Facial nerve hemangioma of the geniculate ganglion: an endoscopic surgical approach. Auris Nasus Larynx 2014; 41:576-81. [PMID: 25217987 DOI: 10.1016/j.anl.2014.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 03/18/2014] [Accepted: 06/17/2014] [Indexed: 11/23/2022]
Abstract
Facial nerve hemangiomas are rare benign tumors arising from the venous plexus surrounding the facial nerve. Surgical management of these tumors is controversial. The goal of surgery is complete tumor removal with restoration of facial nerve function and preservation of hearing, wherever possible. The approaches most used are the translabyrinthine and middle cranial fossa approaches. In this report, we describe the first facial hemangioma treated with an endoscopic transcanal approach, combined with a retroauricular transmastoid minicraniotomy for closure of the dural defect. A great auricular nerve graft was used to reconnect interrupted nerve segments. Histopathological examination confirmed the diagnosis of a hemangioma of the first genu of the facial nerve. With magnification of the structures, the transcanal endoscopic approach allowed a radical excision of the neoplasm permitting hearing function preservation, with the possibility to work with a minimally invasive approach with respect to the labyrinthine block and cochlea. Compared to a middle cranial fossa approach, the transcanal endoscopic approach avoided labyrinthine block removal and brain retraction.
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Yang G, Li C, Chen X, Liu Y, Han D, Gao X, Kawamoto K, Zhao S. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report. Oncol Lett 2014; 8:183-186. [PMID: 24959241 PMCID: PMC4063632 DOI: 10.3892/ol.2014.2143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 04/29/2014] [Indexed: 12/20/2022] Open
Abstract
The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.
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Affiliation(s)
- Guang Yang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China ; Institute of Brain Science, Harbin Medical University, Harbin, Heilongjiang, P.R. China
| | - Chenguang Li
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China ; Institute of Brain Science, Harbin Medical University, Harbin, Heilongjiang, P.R. China
| | - Xin Chen
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China ; Institute of Brain Science, Harbin Medical University, Harbin, Heilongjiang, P.R. China
| | - Yaohua Liu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China ; Institute of Brain Science, Harbin Medical University, Harbin, Heilongjiang, P.R. China
| | - Dayong Han
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China ; Institute of Brain Science, Harbin Medical University, Harbin, Heilongjiang, P.R. China
| | - Xin Gao
- Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Keiji Kawamoto
- Department of Neurosurgery, Kansai Medical University, Osaka, Japan
| | - Shiguang Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China ; Institute of Brain Science, Harbin Medical University, Harbin, Heilongjiang, P.R. China
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Ross L, Drazin D, Eboli P, Lekovic GP. Atypical tumors of the facial nerve: case series and review of the literature. Neurosurg Focus 2013; 34:E2. [PMID: 23452290 DOI: 10.3171/2013.1.focus12380] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECT The authors present a series of 4 patients with rare facial nerve tumors. The relevant literature is reviewed and is discussed regarding diagnostic features, the role of operative management, and surgical approach. METHODS A retrospective chart review was conducted for patients with tumors of the facial nerve that were treated between 2008 and 2011. Patients undergoing observation with serial MRI and those who were treated with up-front radiosurgery and for whom tissue diagnosis was not available were excluded. In addition, patients with suspected vestibular schwannoma, facial nerve schwannoma, neurofibromatosis Type 2, and metastatic disease were also excluded. The charts of 4 patients (2 men and 2 women) with "atypical" tumors were reviewed and analyzed. RESULTS A total of 12 patients with tumors of the facial nerve were identified during the study period. Patient characteristics, preoperative imaging, operative approach, tumor histology, and outcomes are described. CONCLUSIONS Atypical facial nerve tumors must be distinguished from the more common facial nerve schwannoma. How the authors of this study treat rare facial nerve tumors is based on their experience with the more common facial nerve schwannomas, characterized by a slow progression of symptoms and growth. Less is known about the rare lesions, and thus a conservative approach may be warranted. Open questions include the role of radiosurgery, facial nerve decompression, and indications for resection of tumor and cable grafting for these rare lesions.
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Affiliation(s)
- Lindsey Ross
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
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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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Ames JA, Levi JR, Johnston DR, Drake CA, Willcox TO, O'Reilly RC. Atypical presentation of geniculate ganglion venous malformation in a child: conductive hearing loss without facial weakness. Int J Pediatr Otorhinolaryngol 2012; 76:1214-6. [PMID: 22608941 DOI: 10.1016/j.ijporl.2012.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
We describe an unusual presentation of geniculate ganglion venous malformation, a rare facial nerve lesion, emphasizing the importance of the differential diagnosis, imaging characteristics, and controversies in management. A child presented with moderate right-sided conductive hearing loss and a House-Brackmann grade I facial nerve function bilaterally. Computed tomography and magnetic resonance imaging showed a mass demonstrating features consistent with a geniculate ganglion venous malformation. To our knowledge, this is the first pediatric case of geniculate ganglion venous malformation presenting solely with conductive hearing loss. Proper management requires differentiating this condition from other geniculate and temporal bone lesions.
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Affiliation(s)
- Julie A Ames
- Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA
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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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