A case of calvarial hemangioma in cranioplasty site

Abstract

It is not uncommon for hemangiomas to occur in the calvarium, accounting for about 10% of the benign skull tumors. A 46-year-old man was presented with a palpable scalp mass on the left parietal region. Past medical history indicated that he had undergone cranioplasty 25 years prior due to a depressed skull fracture suffered from a traffic accident. Magnetic resonance imaging revealed mixed signal intensity mass on T1 -and T2-weighted images pushing a linear signal void lesion outward in the left parietal region. After total surgical removal along with cranioplasty, he was discharged without neurological deficits. Histological examination of the surgical specimen revealed a cavernous hemangioma. A skull hemangioma occurring at the site of a cranioplasty has not yet been reported. Therefore, authors report this case in combination with a pertinent literature review.

Keywords: Calvarium; Cavernous hemangioma; Cranioplasty.

Fig. 1

Preoperative photographs show a round mass on the left parietal region and a previous skin incision (arrow).

Fig. 2

Preoperative radiological findings. A : Plain skull radiograph shows a radiolucent lesion in the left parietal bone. B : Preoperative magnetic resonance image resonance image shows a left shows a left parietal intradiploic round mass with heterogeneously enhancing signal intensity.

Fig. 3

A : Intraoperative photograph after removal of the mass and the resin plate. B : The removed resin plate. The size was 3.8×3 cm. C : The mass including hematoma.

Fig. 4

Histopathologic pictures illustrating the proliferation of slit-like blood vessels lined by endothelial cells and filled with red blood cells (hematoxylin and eosin, A : ×40, B : ×100, C : ×200).

Fig. 5

Postoperative computed tomography scan shows complete resection of the mass.