Cavernous Sinus Angioleiomyoma: Case Report and Review of the Literature

Cavernous sinus angioleiomyoma (ALM) is extremely rare. Only three cases have been reported to be cavernous sinus ALM, and very few reports described characteristic findings for intracranial ALMs in detail. We report a new case of cavernous sinus ALM, with detailed information on the clinical presentation, radiology, pathology, and surgical approach. A 52-year-old woman had a 6-month history of right eye discomfort. Magnetic resonance imaging showed a right cavernous sinus tumor with heterogenous blush enhancement. Enhanced computed tomography scans and angiography showed small nodular enhancement in the tumor. Complete tumor resection was achieved via an extradural temporopolar approach. ALM was identified based on histologic examination. Intracranial ALMs are different from the ALMs that occur in the extremities based on our review of the literature. Intracranial ALMs appear more frequently in men than women. The cavernous type was the most common pathologically, and they occur often in the epiperidural location. Because cavernous sinus ALM occurs in the interdural space, an epidural approach should be selected. Therefore, it is important to include cavernous sinus ALM into a differential diagnosis of a cavernous sinus tumor. The blush enhancement and nodular enhancement within this lesion may be useful to distinguish cavernous sinus ALM from other differential diagnoses.