Abstract
Introduction Cavernous sinus hemangiomas (CSHs) are rare, vascular, extra-axial tumors that are
diagnosed with a combination of imaging and biopsy. We describe the clinical presentations,
imaging findings, and management of two male patients with CSHs.
Case Report Case 1 describes a 57-year-old man who presented with vision changes and cranial
nerve palsies. Initial imaging and surgical biopsy were nondiagnostic. Follow-up Tc-99m
tagged red blood cell (RBC) imaging supported CSH diagnosis. He was treated with surgical
resection and radiotherapy.
Case 2 describes a 57-year-old man who presented with chronic headache. Imaging findings
were suggestive of CSH. He underwent endoscopic endonasal surgical resection and a
final diagnosis of CSH was made via biopsy.
Discussion CSHs often present with headache, vision changes, and cranial nerve palsies. Characteristic
findings of a T2 hyperintense lesion with homogeneous contrast enhancement has been
described in the literature. There is also a role for tagged RBC imaging studies in
the setting of nondiagnostic imaging and biopsy. Surgical resection can be difficult
due to tumor vascularity and encasement of internal carotid arteries. Stereotactic
radiosurgery and adjuvant radiotherapy can play a role in the treatment of patients
who have inoperable lesions or subtotal resections.
Keywords
hemangioma - cavernous sinus - radiosurgery - nuclear medicine - neuroradiology -
neuroimaging
