Giant primary ossified cavernous hemangioma of the skull in an adult: A rare calvarial tumor

Abstract

Primary intraosseous cavernous hemangiomas (PICHs) of the cranium are rare benign vascular tumors that account for about 0.2 % of all bone tumors and 10 % of benign skull tumors. They generally present as osteolytic lesions with honeycomb pattern of calcification. Completely ossified cavernous hemangioma of the calvarium in an adult has not been reported previously. A 28-year-old female presented to us with a large right parietal skull mass that had been present since the last 15 years. Total resection of the lesion was performed. Pathological examination was suggestive of cavernous hemangioma of the skull bone. Cavernous hemangioma should be considered as one of the differential diagnosis in any case of bony swelling of the calvarium so that adequate preoperative planning can be made to minimize blood loss and subsequent morbidity.

Keywords: Adult; cavernous hemangioma; ossified calvarial mass; skull lesion.

Figure 1

Plain sagittal CT scan showing a completely ossified mass in the high parietal region involving both the inner and outer table of skull

Figure 2

Postcontrast axial CT scan showing a uniformly hyperdense mass in the right high parietal region with contrast enhancing extradural tissue. There is evidence of buckling of underlying gray matter

Figure 3

H and E-stained slide showing bone bits with mature lamellar bone and bony spicules. Medullary spaces between bony trabeculae showing ectatic thin-walled blood vessels with single layer of flat endothelial cells