Petroclival intravascular papillary endothelial hyperplasia with psammoma body‐like structures

Abstract

Masson's tumor or intravascular papillary endothelial hyperplasia (IPEH) is considered a non‐neoplastic lesion. It is probably an unusual exaggerated reorganization of a thrombus. IPEH may be present as a secondary lesion in hemangiomas. Symptomatic osseous hemangiomas are rare tumors. Few cases of clival and petrous bone hemangiomas have been described. None of them shows secondary IPEH. So far, there are only four reported cases of cranial bone IPEHs in the literature, two in the skull, one in the clivus and one in the petrous apex. The aim of this study is to report an additional case of osseous hemangioma with secondary IPEH of the petroclival region. We review the literature and describe the main clinical features of IPEHs and hemangiomas of the clivus and the petrous bone. Additionally, we report an unusual histological feature observed in our case of IPEH, the presence of psammoma body‐like structures. This feature has been rarely mentioned previously in IPEH. We consider that IPEH should be included in the lesions that may present psammoma bodies to avoid misdiagnosing it as a tumor that commonly shows psammoma bodies, such as intraosseous meningioma or, less frequently, metastasis of thyroid or ovarian carcinoma.

Case report: Multiple brain intravascular papillary endothelial hyperplasia: incidence, diagnostic challenges, and management approach

“…Until December 2022, 45 cases of intracranial IPEH have been reported in peer-reviewed literature, mostly as single lesions without parenchymal localization. Out of 45 patients, 18 had secondary cavernous malformation or aneurysm/angioma, often following radiotherapy (5)(6)(7)(8)(9). The median age is 37.5 years, ranging from 2 days to 79 years, with a preponderance in adult age (n = 37/45).…”