Clinical aspects of osseous hemangiomas of the skull base

Abstract

Osseous hemangiomas are distinctly unusual tumors of the skull base. They clinically mimic other, more common lesions in this region, and their diagnosis is rarely made preoperatively with currently available techniques. Three cases of osseous hemangiomata, 2 involving the geniculate region and 1 arising from the jugular bulb, are described in relation to the perioperative assessment and management of these lesions. A review of 21 previously reported skull base hemangiomas is included.

Intraosseous Cavernous Hemangioma of the Frontal Bone -Case Report-

“…1) These characteristics are better defined by CT, especially for smaller lesions that are not obvious on radiographs. [4][5][6][7] The cortex can be greatly expanded, leaving a thin bony shell, although the periosteum remains intact, in contrast to osteogenic sarcomas, which destroy the bone cortex and invade the periosteum and surrounding soft tissues. There is usually no reactive sclerosis at the margins.…”

“…These trabeculations are the result of reactive osteoclastic and osteoblastic bone remodeling in response to the stress created by the enlarging vascular neoplasm, and appear continuous with the normal surrounding bone. 5) Cavernous-type PICH consists of thin-walled vascular channels lined by a single layer of flattened endothelial cells interspersed among the bony trabeculae. 13) Capillary hemangiomas, which are the other, less common form of hemangioma, consist of radially directed capillary loops lined by a single layer of cuboidal endothelial cells.…”

“…Gross total surgical excision is generally recommended to minimize cosmetic deformity and to obtain a definitive diagnosis. 1,5,7,11) The surgical treatment of choice is en bloc excision and establishment of normal bony margins by drill curettage.…”

“…8) The parietal and frontal bones are the most common sites of involvement. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] The pathogenesis is unknown, but is believed to be either congenital or related to previous trauma. 3) We describe a case of PICH of the frontal bone, involving the bony component of the frontal sinus, which was completely removed without injury to the frontal sinus mucosa.…”

Intratemporal Hemangiomas Involving the Facial Nerve: Diagnosis and Management

“…Facial nerve dysfunction is more common when the tumors are situated at the GG, and many patients present as having recurrent Bell's palsy.2 Thus, the relative rarity and their variable clinical presentation along with paucity of clinical experience with these lesion often leads to delayed diagnosis. 3 The aim of this study is to present our experience in a series of 21 intratemporal vascular tumors (hemangiomas and vascular malformations) involving the facial nerve operated on by the senior authors (A.M., M.S. ), emphasizing their variable clinical presentations and the relevant surgical management.…”