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

Alvaro Bravo-Martinez, Amanda P. Marrero-Gonzalez, Mohammad N. Suleiman-Suleiman, Juan C. Vicenty-Padilla, Elizabeth Trullenque-Martinez

(Department of Diagnostic Radiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico)

Am J Case Rep 2019; 20:525-530

DOI: 10.12659/AJCR.913414

BACKGROUND: Intraosseous cavernous skull hemangiomas are rare benign vascular tumors that are usually found incidentally on imaging, with an asymptomatic and slow-growing course. We present a case in which the patient had a mass on her forehead for many years, which began to grow rapidly after head trauma. Imaging characteristics play a crucial role in the diagnosis and description of this disease, and in differentiating it from other more common calvarial lesions that may present with a similar clinical picture. Here, we report an unusual presentation of a large skull hemangioma and discuss the different radiologic imaging findings and pathologic correlations.
CASE REPORT: A 58-year-old female with history of a lump on her forehead since childhood, which began to grow rapidly after experiencing a closed-head injury. Due to its large size, she went on to seek further management. Radiologic images revealed a frontal skull lesion suggestive of an intraosseous hemangioma. She underwent embolization of the tumor, and 2 days later underwent bilateral frontal craniectomy and cranioplasty. Histopathologic findings confirmed this diagnosis.
CONCLUSIONS: Intraosseous skull hemangioma may be confidently diagnosed and differentiated from other skull lesions by its imaging characteristics. An accurate diagnosis is essential to selecting correct management and avoiding complications.

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