The cranial CT with a bone window is the diagnostic modality of choice, since it surpasses the sensitivity of simple radiography and allows bone to be defined in a superior way to MRI, giving a detailed image of the cortical and trabecular bone. Although the appearance in the CT can vary, the characteristic image consists of alytic lesion, oval or rounded, expansive, and well delimited, with trabeculae that radiate from a common center in its interior in the tangential cuts, giving sometimes an appearance of honeycombing in the axial cuts. It frequently invades and expands the external table, respecting the periosteum. Usually no signs of reactive hyperostosis are identified at their margins. The cortex can undergo a great expansion leaving a thin bone layer, but in almost all cases, the periosteum remains intact and usually without reactive sclerosis at the margins. The angiography of these lesions, typically the largest, demonstrates a hypervascular lesion, but without drainage veins. Preoperative embolization may be useful in some cases.
Author(s) Details:
Alejandra Arévalo Sáenz
Neurosurgery Service of the San Carlos University Hospital, C/ Profesor Martín Lagos S/N, Monclo 28040 Madrid, Spain.
Borja Ferrández Pujante
Neurosurgery Service of the San Carlos University Hospital, C/ Profesor Martín Lagos S/N, Monclo 28040 Madrid, Spain.
Fernando J. Rascón-Ramírez
Neurosurgery Service of the San Carlos University Hospital, C/ Profesor Martín Lagos S/N, Monclo 28040 Madrid, Spain.
Recent Global Research Developments in Management of Intraosseous Cavernous Hemangioma: A Case Study
Surgical Treatment of Aggressive Intraosseous Cavernous Hemangioma in Maxilla:
This study reports a case of a right maxillary cavernous intraosseous hemangioma treated by surgical resection with previous embolization. The diagnosis was made through incisional biopsy and immunohistochemical examination. The patient remained stable after 30 months of follow-up without relapses [1] .
Primary Intraosseous Cavernous Hemangioma of the Clivus:
This case report describes a 57-year-old woman with a clival PICH mimicking a chordoma. The lesion was removed using an endoscopic transsphenoidal approach. Histologically, it was diagnosed as an intraosseous cavernous hemangioma [2] .
Pediatric Cranial Intraosseous Hemangiomas:
This review discusses a case of cranial vault mixed capillary-cavernous hemangioma in a child and extensively reviews the literature on pediatric intraosseous hemangiomas of the cranium [3] .
Primary Intraosseous Cavernous Hemangioma of the Clivus: Case Report:
This report presents a patient case with a review of recent pertinent literature, highlighting the challenges in diagnosing and managing these rare lesions [4] .
Intraosseous Cavernous Hemangioma in the Mandible:
This case report discusses a 28-year-old male patient with a painless swelling of the mandible, diagnosed as an intraosseous cavernous hemangioma. The clinical and radiological features are discussed in detail5.
References
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- Prasad, G.L., Pai, K. Pediatric cranial intraosseous hemangiomas: a review. Neurosurg Rev 41, 109–117 (2018). https://doi.org/10.1007/s10143-016-0779-7
- Gologorsky Y, Shrivastava RK, Panov F, et al. Primary intraosseous cavernous hemangioma of the clivus: case report and review of the literature. Journal of Neurological Surgery Reports. 2013 Jun;74(1):17-22. DOI: 10.1055/s-0033-1346980. PMID: 23943715; PMCID: PMC3713557.
- Elif, B., Derya, Y., Gulperi, K., & Sevgi, B. (2017). Intraosseous cavernous hemangioma in the mandible: a case report. Journal of clinical and experimental dentistry, 9(1), e153.
