Posttraumatic skull hemangioma: case report

Case report: Cavernous hemangioma in the right frontoparietal junction

Background

Primary intraosseous cavernous hemangioma is a benign tumor with slow growth and is rarely seen in clinics. The clinical manifestations of most patients are progressive enlargement of the head mass.

Case presentation

We report a 30-year-old female patient with cavernous hemangioma at the frontoparietal junction. Upon admission, the right frontal lobe mass was progressively enlarged for 3 years and underwent lesion resection and stage I skull reconstruction. The postoperative outcome was good, with no recurrence at 1-year follow-up.

Conclusion

Primary intraosseous cavernous hemangioma is a relatively rare clinical tumor, the pathogenesis of which is still unclear, and most of them have no specific clinical manifestations. Characteristic imaging findings are highly suspicious of this disease, but the definitive diagnosis still depends on histopathological examination. Currently, total surgical resection of the tumor is a relatively effective and preferred treatment.

68Ga-DOTATATE Uptake in an Intraosseous Hemangioma, as a Potential Cause of False-Positive PET/CT Finding, Simulating Tumoral Involvement

ABSTRACT

We present the case of a 32-year-old man with a history of hypophosphatemia and multiple bone fractures, being evaluated at our center for a potential mesenchymal tumor. 68Ga-DOTATATE PET/CT revealed a highly 68Ga-DOTATATE-avid lesion in the ethmoidal sinus extending to the nasal cavity. Following resection, histologic examination of the specimen confirmed the diagnosis of "intraosseous hemangioma," a potential cause of false-positive finding of 68Ga-DOTATATE PET/CT imaging in patients being evaluated for occult malignancies, especially at the traumatic/fractured sites.

Orbitofrontal Reconstruction With a Three-Dimensional Titanium Patient-Specific Implant After Intraosseous Haemangioma Resection

BACKGROUND

Intraosseous hemangiomas are rare benign tumors that can develop in the skull. Orbitofrontal localization is uncommon. The complexity of orbitofrontal anatomy results in difficult reconstruction following trauma or tumoral resection.

CASE PRESENTATION

A 50-year-old woman with a right orbitofrontal intraosseous hemangioma was referred to our department. The authors decided to perform tumoral bone resection and orbitofrontal reconstruction using virtual surgical planning in collaboration with Materialize engineers (Materialise, Leuven, Belgium). Three cutting guides and a patient-specific 3-dimensional (3D) titanium implant were designed and manufactured in 3 weeks. Surgery was performed with a double surgical team composed of maxillofacial surgeons and neurosurgeons. No perioperative or post-operative complications occurred. Post-operatively, the patient was completely asymptomatic and clinical examination showed symmetrical and satisfactory facial morphology.

CONCLUSION

Virtual surgical planning, design of patient-specific guides and manufacturing of implants make surgery easier and increase surgical precision. This technique is recommended for wide use in cases of oncological or complex trauma craniomaxillofacial reconstruction.

What's that big thing on your head? Diagnosis of a large frontoparietal lesion on an Eastern Zhou skull from Henan, China

We carried out a differential diagnosis of a large frontoparietal lesion on a human skull from a Late Bronze Age archaeological site located on the Central Plain of China, dating to between 771 and 476 BC. The head of this individual was covered in cinnabar, a mercury-based pigment that later was used for medicinal purposes in China. The lesion was well-circumscribed and involved the outer and inner tables of the skull, slight diploë thickening, and coarsening of bone trabeculae with expansion of intertrabecular spaces. We show that the observed changes are most consistent with cavernous hemangioma of the skull, a benign vascular malformation that preferentially affects older adults. Hemangiomas are often neglected in the paleopathological literature because of their benign nature - they tend to be asymptomatic and do not affect quality of life to a significant degree. Nevertheless, they produce characteristic lesions that can be confused with several other conditions with unrelated etiologies, including congenital hemoglabinopathies, traumas, malignant or benign neoplasms, and Paget's disease. We outline the diagnostic criteria that distinguish cavernous hemangioma from other conditions affecting the skull.

Radiologic Features with Pathologic Correlation of an Unusual Large Intraosseous Skull Cavernous Hemangioma

Patient: Female, 58

Final Diagnosis: Intraosseous skull hemangioma

Symptoms: Palpable, painless hard mass in forehead • no headaches, altered mental status, seizures, or focal neurological deficit

Medication: —

Clinical Procedure: Cerebral angiogram and embolization of feeders • afterwards, she underwent a bifrontal craniectomy and cranioplasty

Specialty: Radiology

Diffuse cavernous hemangioma of the skull misdiagnosed as skull metastasis in breast cancer patient: one case report and literature review

Background

Primary intraosseous cavernous hemangiomas (PICHs) of the skull are extremely rare. To date, diffuse cranial hemangioma of skull has not been reported. In cancer patients, it is often misdiagnosed as metastasis.

Case presentation

Here, we presented a case of a 50-year-old female patient suffering from slightly headache who received breast cancer modified radical mastectomy in 2004, computed tomography and magnetic resonance imaging findings revealed abnormal lesions of diffuse skull which were misdiagnosed as skull metastasis, and the relevant literatures were also reviewed.

Conclusions

Diffuse cavernous hemangioma of the skull is exceedingly rare, and imaging data are not typical. The condition is often misdiagnosed, and pathological evaluation is necessary and important. In cases where the mass cannot be completely removed by surgery, radiotherapy could be beneficial.

Calvarial bone cavernous hemangioma with intradural invasion: An unusual aggressive course-Case report and literature review

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Calvarial cavernous hemangiomas are benign tumors.

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These tumors tend to involve the outer table of the skull.

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More extensive involvement of the inner table and extradural space is very unusual.

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We present a case of a huge frontal cavernoma with intradural extension.

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Our case highlights the possibility of an aggressive course of this rare benign pathology.

Introduction

Cavernous hemangioma of the skull is a rare pathological diagnosis, accounting for 0.2% of bone tumors and 7% of skull tumors. Usually calvarial bone cavernous hemangioma are associated with a benign clinical course and, despite their enlargement and subsequent erosion of the surrounding bone, the inner table of the skull remains intact and the lesion is completely extracranial.

Presentation of a case

The authors present the unique case of a huge left frontal bone cavernous malformation with intradural extension and brain compression determining a right hemiparesis.

Discussion

Calvarial cavernous hemangiomas are benign tumors. They arise from vessels in the diploic space and tend to involve the outer table of the skull with relative sparing of the inner table. More extensive involvement of the inner table and extradural space is very unusual and few cases are reported in literature. To the best of our knowledge, intradural invasion of calvarial hemangioma has not been previously reported.

Conclusion

Our case highlights the possibility of an aggressive course of this rare benign pathology.

Posttraumatic cavernous hemangioma of the skull

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.

Cavernous hemangioma of the skull and meningioma: association or coincidence?

Intraosseous cavernous hemangiomas of the skull are rare. Meningiomas are quite frequently encountered in a neurosurgical practice. The association between these two entities is nevertheless very uncommon. The authors present a case of a 72-year-old woman suffering from headache. The MRI showed a parietal meningioma with adjacent thick bone. The meningioma and the bone were removed. The histological examination confirmed the diagnosis of meningioma and revealed a cavernoma of the skull. The relationship between the lesions suggests more than a coincidental association. Several hypotheses are proposed to explain common causal connections.

Desmoplastic fibroma of the pediatric cranium: case report and review of the literature

PURPOSE

Desmoplastic fibromas are primary bone tumors that seldom occur in the cranial bones. Furthermore, reports of desmoplastic fibromas of the skull in children are exceedingly rare. Although desmoplastic fibromas are histologically benign, they are locally aggressive and have a propensity to reoccur. Their radiographic appearance may mimic other more common central nervous system and bone neoplasms. There are only 19 reported cases of desmoplastic fibroma of the cranium in the literature, and only seven occurred in the pediatric age group. We present a case report of an 11-year-old female patient with a desmoplastic fibroma of the parieto-occipital region and review the literature.

CASE REPORT

An 11-year-old female presented to the craniofacial clinic complaining of intermittent pain and a soft mass in the occipital region. There was a distant history of trauma to the region that did not require medical intervention. Computed tomography imaging revealed a lytic bone lesion overlying the sagittal sinus in the parieto-occipital region. Surgical resection with wide margins and immediate autologous reconstruction was performed. Pathological analysis revealed a desmoplastic fibroma. At 4 months of follow-up, no recurrence has been noted.

CONCLUSION

Desmoplastic fibroma of the cranium is rare. Complete surgical resection with careful follow-up is the treatment of choice.