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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.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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