Intraosseous Orbital Cavernous Hemangioma with Frontal Extension and Dural Involvement.

Gabriela Espinoza,Georgios Alexopoulos,Najib El Tecle,Jeroen Coppens,Asad Akther

doi:10.7759/cureus.4823

Gabriela Espinoza, Georgios Alexopoulos + Show 3 more

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https://doi.org/10.7759/cureus.4823

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Journal: Cureus	Publication Date: Jun 4, 2019
Citations: 3	License type: cc-by

Affiliation: Saint Louis University Hospital

Abstract

Primary intraosseous cavernous hemangiomas are rare skull lesions that are not typically known to involve the orbital bones or the dura. We describe a rare case of a fronto-orbital bone cavernous hemangioma with extension into the dura.A 68-year-old female presented with a one-year history of diplopia with discomfort around her left orbit. Magnetic resonance images demonstrated a mass in the left frontal skull extending into the orbital rim. The patient underwent a craniotomy for tumor resection. Dural invasion was found intraoperatively. Gross total resection and reconstruction were achieved. On the postoperative follow-up, the patient was asymptomatic. Primary calvarial intraosseous cavernous hemangiomas are most commonly located in the frontal and parietal bones. These lesions typically involve only the outer table of the skull. In lesions involving the orbit and dura, excision with cranioplasty can provide symptomatic relief with good cosmetic outcomes.

Highlights

Primary intraosseous cavernous hemangiomas are rare, benign vascular lesions, accounting for 0.2% of bone tumors and 7% of skull tumors [1]
We describe a rare case of a fronto-orbital bone cavernous hemangioma with extension into the dura
We present a unique and rare case of a fronto-orbital bone cavernous hemangioma with an extension of the hemangioma beyond the inner table and with the involvement of the dura

Summary

Introduction

Primary intraosseous cavernous hemangiomas are rare, benign vascular lesions, accounting for 0.2% of bone tumors and 7% of skull tumors [1]. We present a unique and rare case of a fronto-orbital bone cavernous hemangioma with an extension of the hemangioma beyond the inner table and with the involvement of the dura. A computed tomography (CT) scan of the head without contrast demonstrated a wellcircumscribed, expansile 5.3 cm x 3.7 cm x 4.5 cm mass with coarse internal trabeculations and sclerotic margins in the supraorbital left frontal bone, consistent with an intraosseous hemangioma (Figure 2). Gross examination of the left frontal bone specimens sent during surgery demonstrated redwhite bony tissue (Figure 4). At her one month follow-up, the patient continued to have no complaints of diplopia, as well as no complaints of pain or the sensation of pressure and fullness behind the left orbit. The patient remained asymptomatic at four months of follow-up with stable imaging

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