Intratumoral injection of biobond adhesive for removal of cavernous sinus hemangioma

Abstract

The authors present a case in which a cavernous sinus (CS) hemangioma was totally removed following intratumoral injection of a plastic fixation material. This unique method is extremely useful for the removal of CS hemangiomas, which often feature massive intraoperative bleeding as an unsolved problem.

The role of stereotactic radiosurgery in cavernous sinus hemangiomas: a systematic review and meta-analysis

“…Treatment of patients with cavernous sinus hemangiomas has generated interest in recent years because the results of surgical intervention are unfavorable, even if new surgical techniques, for example the extradural approach and induced systemic hypotension, are applied [17][18][19][20]. According to some published reports, the lesions are quite radiosensitive; radiosurgery and conventional radiotherapy should therefore be important in overall management [21][22][23][24][25].…”

“…We divided these 55 cases into two groups on the basis of treatment response shown on the most recent MR images available. Remarkable tumor shrinkage was demonstrated in 39 (70.9%) of 55 patients and the mean radiation dose received was 14 Gy (range [10][11][12][13][14][15][16][17][18][19]. The mean radiation dose received by 16 patients with partial or no change tumor shrinkage was 13.5 Gy (range [10][11][12][13][14][15][16].…”

Non-meningeal tumours of the cavernous sinus: A surgical analysis

“…65 Several other methods of haemostasis, including intratumoural fibrin glue or plastic adhesive injection, or induced hypotension, have been proposed, but early devascularisation and enbloc removal ensures the most direct means of achieving haemostasis. 63,[66][67][68] In our experience, gamma knife radiosurgery has also been very effective in the primary treatment of cavernous sinus haemangiomas. 69 This finding is supported by several other reports.…”

Merits of intralesional fibrin glue injection in surgery for the cavernous sinus cavernous hemangiomas

“…11 On the contrary, it is often difficult to remove large or giant tumors totally without performing a debulking procedure by incising the capsule. 7,8,10 For the safe removal of CS cavernous hemangiomas for which embolization is not possible, as shown in this report, some authors have suggested that a superior approach to the cavernous ICA be followed at an early operative stage to interrupt the main feeding source. 11,27 This procedure is not peformed easily until internal de-compression of the lesion has been completed from the lateral approach.…”

“…With regard to their diagnosis, the evidence of bone erosion on CT scans, marked hyperintensity on T 2 -weighted MR images, and little to no angiographic blush are characteristic imaging findings. 8,23,30 Two subtypes of cavernous hemangioma of the CS were documented in a pathological report, 27 which revealed marked differences in light microscopic features, difficulty in hemostasis, tumor hardness, and resectability.…”