BackgroundCapillary hemangiomas of the central nervous system are exceedingly rare. These are benign tumour-like lesions that usually occur in the skin and soft tissues of mainly children. We report the case of an extra-axial capillary hemangioma mimicking a tentorial meningioma.Case presentationA 46-year old female patient presented with headaches. Imaging revealed an avidly enhancing tentorial lesion with a wide dural base, features suggestive of a meningioma. Intra-operatively, an extra-axial heavily vascular tumour was found and was radically resected en bloc. Histology revealed thin-walled capillary-sized vessels arranged in closely packed lobules, and a diagnosis of capillary hemangioma was made. At one year follow up, the patient was asymptomatic and no tumour recurrence was noted.ConclusionsA literature review showed that capillary hemangiomas may be misdiagnosed as other extra-axial dural-based lesions such as meningiomas, schwannomas, hemangiopericytomas and inflammatory granulomatous lesions. Diagnosis should be considered especially in radiologically atypical cases. Complete excision is curative. Stereotactic radiosurgery on its own or in conjunction with surgery also achieves good results while partial excision or biopsy alone often leads to recurrence.

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