Skull Base 2003; 13(4): 219-228
DOI: 10.1055/s-2004-817698
CASE REPORT

Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Primary Intraosseous Skull Base Cavernous Hemangioma: Case Report

James K. Liu1 , Peter C. Burger2 , H. Ric Harnsberger3 , William T. Couldwell1
  • 1Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah
  • 2Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
  • 3Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
Further Information

Publication History

Publication Date:
03 February 2004 (online)

ABSTRACT

Primary intraosseous cavernous hemangiomas (PICHs) of the skull base are extremely rare tumors. These lesions are most common in the frontal and parietal bones of the calvarium. The authors describe a 40-year-old female who presented with progressive headaches. Serial imaging revealed a contrast-enhancing intraosseous lesion of the lateral body of the sphenoid bone and the greater wing associated with encroachment of the inferior cavernous sinus and mild posterior displacement of the cavernous carotid artery. Follow-up imaging 9 years later revealed slow growth of the lesion. The patient underwent complete excision of the PICH through an extradural frontopolar approach. Pathological examination revealed an intraosseous cavernous hemangioma. PICHs of the skull base can mimic other more common skull base lesions and thus can be difficult to diagnose preoperatively. Diagnosis is usually made at surgery. The authors review the literature regarding the clinical presentation, radiological characteristics, pathological features, and surgical management of PICHs.

REFERENCES

  • 1 Wyke B D. Primary hemangioma of skull. A rare cranial tumour.  AJR Am J Roentgenol . 1946;  61 302-316
  • 2 Nakahira M, Kishimoto S, Miura T, Saito H. Intraosseous hemangioma of the vomer: a case report.  Am J Rhinol . 1997;  11 473-477
  • 3 Moore S L, Chun J K, Mitre S A, Som P M. Intraosseous hemangioma of the zygoma: CT and MR findings.  AJNR Am J Neuroradiol . 2001;  22 1383-1385
  • 4 Cuesta G, Navarro-Vila C. Intraosseous hemangioma of the zygomatic bone. A case report.  Int J Oral Maxillofac Surg . 1992;  21 287-291
  • 5 Ozdemir R, Alagoz S, Uysal A C, Unlu R E, Ortak T, Sensoz O. Intraosseous hemangioma of the mandible: a case report and review of the literature.  J Craniofac Surg . 2002;  13 38-43
  • 6 Guibert-Trainer F, Piton J, Riche M C, Merland J J, Caille J M. Vascular malformations of the mandible (intraosseous haemangiomas). The importance of preoperative embolization. A study of 9 cases.  Eur J Radiol . 1982;  2 257-272
  • 7 Stassi J, Rao V M, Lowry L. Hemangioma of bone arising in the maxilla.  Skeletal Radiol . 1984;  12 187-191
  • 8 Banerji D, Inao S, Sugita K. Primary intraosseous orbital hemangioma: a case report and review of the literature.  Neurosurgery . 1994;  35 1131-1134
  • 9 Relf S J, Bartley G B, Unni K K. Primary orbital intraosseous hemangioma.  Ophthalmology . 1991;  98 541-547
  • 10 Slaba S G, Karam R H, Nehme J I, Nohra G K, Hachem K S, Salloum J W. Intraosseous orbitosphenoidal cavernous angioma. Case report.  J Neurosurg . 1999;  91 1034-1036
  • 11 van Loveren R H, Keller J T, el-Kalliny M, Scodary D J, Tew Jr M J. The Dolenc technique for cavernous sinus exploration (cadaveric prosection). Technical note.  J Neurosurg . 1991;  74 837-844
  • 12 Dolenc V V. Extradural approach to intracavernous ICA aneurysms.  Acta Neurochir Suppl (Wien) . 1999;  72 99-106
  • 13 Dolenc V V. Frontotemporal epidural approach to trigeminal neurinomas.  Acta Neurochir (Wien) . 1994;  130 55-65
  • 14 Peterson D L, Murk S E, Story J L. Multifocal cavernous hemangioma of the skull: report of a case and review of the literature.  Neurosurgery . 1992;  30 778-781
  • 15 Toynbee J. An account of two vascular tumours developed in the substance of bone.  Lancet . 1845;  2 676.
  • 16 McIntyre N G, Brebner D M, Gluckman J. The cavernous haemangioma of the frontal bone. A case report.  S Afr Med J . 1977;  52 537-538
  • 17 Gupta S D, Tiwari I N, Pasupathy N K. Cavernous haemangioma of the frontal bone: case report.  Br J Surg . 1975;  62 330-332
  • 18 Sinnreich Z, Kremer S, Sade J, Bernheim J. Cavernous hemangioma of the frontal bone.  ORL J Otorhinolaryngol Relat Spec . 1990;  52 269-272
  • 19 Sharma R R, Pawar S J, Lad S D, Netalkar A S, Musa M M. Frontal intraosseous cryptic hemangioma presenting with supraorbital neuralgia.  Clin Neurol Neurosurg . 1999;  101 215-219
  • 20 Hook S R, Font R L, McCrary J A. Intraosseous capillary hemangioma of the frontal bone.  Am J Ophthalmol . 1987;  103 824-827
  • 21 Hoffman D F, Israel J. Intraosseous frontal hemangioma.  Head Neck . 1990;  12 160-163
  • 22 Pastore F S, De Caro M G, Faiola A, Mauriello A, Giuffre R. Cavernous hemangioma of the parietal bone. Case report and review of the literature.  Neurochirurgie . 1999;  45 312-315
  • 23 de Ponte S F, Bottini D J, Valentini V. Surgical treatment of hemangioma of bones of the orbito-zygomatic region.  Minerva Stomatol . 1994;  43 365-372
  • 24 Vargel I, Cil B E, Er N, Ruacan S, Akarsu A N, Erk Y. Hereditary intraosseous vascular malformation of the craniofacial region: an apparently novel disorder.  Am J Med Genet . 2002;  109 22-35
  • 25 Gross H J, Roth A M. Intraosseous hemangioma of the orbital roof.  Am J Ophthalmol . 1978;  86 565-569
  • 26 Hornblass A, Zaidman G W. Intraosseous orbital cavernous hemangioma.  Ophthalmology . 1981;  88 1351-1355
  • 27 Kolasa P, Januszalwasiak, Kordek R, Boronski K. Intraosseous orbital haemangioma.  Folia Neuropathol . 2001;  39 37-39
  • 28 Mortada A. Exopththalmos and rare tumors of the orbital bones.  Am J Ophthalmol . 1964;  57 270-275
  • 29 Kiratli H, Orhan M. Multiple orbital intraosseous hemangiomas.  Ophthal Plast Reconstr Surg . 1998;  14 345-348
  • 30 Okada A A, Shore J W, Rubin P A. Periorbital intraosseous hemangiomas.  Int Ophthalmol Clin . 1992;  32 111-121
  • 31 Hwang K. Intraosseous hemangioma of the orbit.  J Craniofac Surg . 2000;  11 386-387
  • 32 Bottrill I, Poe D S. Imaging quiz case 2. Intraosseous cavernous-type hemangioma of the petrous temporal bone.  Arch Otolaryngol Head Neck Surg . 1995;  121 348
  • 33 Curtin H D, Jensen J E, Barnes Jr L, May M. Ossifying” hemangiomas of the temporal bone: evaluation with CT.  Radiology . 1987;  164 831-835
  • 34 Glasscock M E, Smith P G, Schwaber M K, Wissen A J. Clinical aspects of osseous haemangiomas of the skull base.  Laryngoscope . 1984;  94 869-873
  • 35 Irgens E R. Haemangioma of skull involving right petrous and occipital bone.  Arch Otolaryngol . 1939;  29 709-712
  • 36 Bucy P C, Capp C S. Primary hemangioma of bone with special reference to roentgenologic diagnosis.  AJR Am J Roentgenol . 1930;  23 1-33
  • 37 Kessler L A, Lubic L G, Koskoff Y D. Epidural haemorrhage secondary to cavernous haemangioma of the petrous portion of the temporal bone.  J Neurosurg . 1957;  14 329-331
  • 38 Friedman O, Neff B A, Wilcox T O, Kenyon L C, Sataloff R T. Temporal bone hemangiomas involving the facial nerve.  Otol Neurotol . 2002;  23 760-766
  • 39 Gavilan J, Nistal M, Gavilan C, Calvo M. Ossifying hemangioma of the temporal bone.  Arch Otolaryngol Head Neck Surg . 1990;  116 965-967
  • 40 Eby T L, Fisch U, Makek M S. Facial nerve management in temporal bone hemangiomas.  Am J Otol . 1992;  13 223-232
  • 41 Garcia-Martin V, Ravina J, Trujillo E, Gonzalez-Feria L. Symptomatic cavernous hemangioma of the occipital condyle treated with methacrylate embolization.  Surg Neurol . 2001;  56 301-303
  • 42 Rajshekhar V, Chandy M J. Haemangioma of the skull base producing basilar impression.  Br J Neurosurg . 1989;  3 229-233
  • 43 Tashiro T, Inoue Y, Nemoto Y. Cavernous hemangioma of the clivus: case report and review of the literature.  AJNR Am J Neuroradiol . 1991;  12 1193-1194
  • 44 Dickins J R. Cavernous hemangioma of the sphenoid wing.  Arch Otolaryngol . 1978;  104 58-60
  • 45 Suss R A, Kumar A J, Dorfman H D. Capillary hemangioma of the sphenoid bone.  Skeletal Radiol . 1984;  11 102-107
  • 46 Sweet C, Silbergeit R, Mehta B. Primary intraosseous hemangioma of the orbit: CT and MR appearance.  AJNR Am J Neuroradiol . 1997;  18 379-381
  • 47 Lobato R D, Lamas E, Amor T, Rivas J J. Primary calvarial hemangioma: angiographic study.  Surg Neurol . 1978;  10 389-394
  • 48 Simmons J B, Wolpert S M. Angiography of calvarial hemangioma. Report of a case.  Radiology . 1969;  93 328-330
  • 49 Pompili A, Guiot G, Moret J. Sphenoid ridge haemangioma operated on after feeding artery embolization. Case report.  Acta Neurochir (Wien) . 1982;  64 125-132
  • 50 Cushing H. Surgical end-results in general, with a case of cavernous haemangioma of the skull in particular.  Surg Gynecol Obstet . 1923;  36 303-308
  • 51 Tsao M N, Schwartz M L, Bernstein M. Capillary hemangioma of the cavernous sinus. Report of two cases.  J Neurosurg . 2003;  98 169-174
  • 52 Zucker J J, Levine M R, Chu A. Primary intraosseous hemangioma of the orbit. Report of a case and review of the literature.  Ophthal Plast Reconstr Surg . 1989;  5 247-255
  • 53 Fredrickson J M, Haight J SH, Noyek A M. Radiation induced carcinoma in a haemangioma.  Otolaryngol Head Neck Surg . 1979;  87 584-586
  • 54 Furst C J, Lundell M, Holm L E. Radiation therapy for hemangiomas, 1909-1959. A cohort of 50 years of clinical practice at Radiumhemmet, Stockholm.  Acta Oncol . 1987;  26 33-36
  • 55 Nakamura N, Shin M, Tago M. Gamma knife radiosurgery for cavernous hemangiomas in the cavernous sinus. Report of three cases.  J Neurosurg . 2002;  97 (suppl 5) S477-S480
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