Surgical Management of a Superior Orbital Fissure Cavernous Hemangioma

Abstract

Background: Cavernous sinus hemangiomas (CSHs) are intracranial extradural benign, well-demarcated neoplasms arising within dural sinuses. The orbital apex and superior orbital fissure (SOF) are common locations for these lesions. Because of the complex anatomy of this area and potential morbidity, SOF CSH surgical management is challenging.

Objective: Describe a case of a SOF CSH and review of literature.

Material and methods: We present the case of a 44-year-old female with a 2-month history of right eye visual disturbances. A contrast-enhanced magnetic resonance imaging showed a right orbital apex nodular formation. A pterional craniotomy with a middle fossa mini peeling was performed.

Results: Gross total resection was accomplished. No recurrences were observed 2 years after surgery.

Conclusion: SOF CSH should be included in a differential diagnosis in cases of space-occupying orbital apex lesions with atypical features. Surgery is the gold standard treatment. Radiosurgery is a valid option for tumor remnants.

Keywords: Cavernous sinus hemangioma; extradural approach; middle fossa peeling; superior orbital fissure.