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A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report

RATIONALE: Central nervous system (CNS) solid cavernous hemangiomas are rare extra-axial anomalies that may sometimes resemble meningiomas. Due to their complex vascular nature, accurate preoperative diagnosis is important to avoid disastrous hemorrhage during operation. To the best of our knowledge...

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Autores principales: Lan, Zhigang, Richard, Seidu A., Li, Jin, Xu, Jianguo, You, Chao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221700/
https://www.ncbi.nlm.nih.gov/pubmed/30383694
http://dx.doi.org/10.1097/MD.0000000000013098
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author Lan, Zhigang
Richard, Seidu A.
Li, Jin
Xu, Jianguo
You, Chao
author_facet Lan, Zhigang
Richard, Seidu A.
Li, Jin
Xu, Jianguo
You, Chao
author_sort Lan, Zhigang
collection PubMed
description RATIONALE: Central nervous system (CNS) solid cavernous hemangiomas are rare extra-axial anomalies that may sometimes resemble meningiomas. Due to their complex vascular nature, accurate preoperative diagnosis is important to avoid disastrous hemorrhage during operation. To the best of our knowledge this is the first case in an adolescent since all middle cranial fossa hemangioma cases reported in literature are adults in their 40s or 50s and all the pediatric cases are cystic. PATIENT CONCERNS: We present a case of a 14-year-old girl with headache and dizziness for 3 months. She occasionally experienced nausea and vomiting but denied visual disturbances and loss of smell. DIAGNOSES: MRI revealed a lesion that extends to the greater wing of the sphenoid bone as well as the pituitary fossa. Our initial diagnosis was a sphenoid wing meningioma but interestingly, histopathology revealed solid cavernous hemangioma. INTERVENTIONS: The residual tumor was completely removed with 2 sessions of Gamma Knife radiotherapy after surgery. OUTCOMES: We were confronted with excessive bleeding during surgery so we attained subtotal resection. However, the patient recovered well with no recurrence of the tumor. LESSONS: Our case shows that space occupying lesions involving the cavernous sinus and sphenoid ridged could be easily misdiagnosed as sphenoid wing meningiomas in children and adolescents and even adults therefore great care must be exercised when confronted with this kind of presentation.
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spelling pubmed-62217002018-12-04 A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report Lan, Zhigang Richard, Seidu A. Li, Jin Xu, Jianguo You, Chao Medicine (Baltimore) Research Article RATIONALE: Central nervous system (CNS) solid cavernous hemangiomas are rare extra-axial anomalies that may sometimes resemble meningiomas. Due to their complex vascular nature, accurate preoperative diagnosis is important to avoid disastrous hemorrhage during operation. To the best of our knowledge this is the first case in an adolescent since all middle cranial fossa hemangioma cases reported in literature are adults in their 40s or 50s and all the pediatric cases are cystic. PATIENT CONCERNS: We present a case of a 14-year-old girl with headache and dizziness for 3 months. She occasionally experienced nausea and vomiting but denied visual disturbances and loss of smell. DIAGNOSES: MRI revealed a lesion that extends to the greater wing of the sphenoid bone as well as the pituitary fossa. Our initial diagnosis was a sphenoid wing meningioma but interestingly, histopathology revealed solid cavernous hemangioma. INTERVENTIONS: The residual tumor was completely removed with 2 sessions of Gamma Knife radiotherapy after surgery. OUTCOMES: We were confronted with excessive bleeding during surgery so we attained subtotal resection. However, the patient recovered well with no recurrence of the tumor. LESSONS: Our case shows that space occupying lesions involving the cavernous sinus and sphenoid ridged could be easily misdiagnosed as sphenoid wing meningiomas in children and adolescents and even adults therefore great care must be exercised when confronted with this kind of presentation. Wolters Kluwer Health 2018-11-02 /pmc/articles/PMC6221700/ /pubmed/30383694 http://dx.doi.org/10.1097/MD.0000000000013098 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Lan, Zhigang
Richard, Seidu A.
Li, Jin
Xu, Jianguo
You, Chao
A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report
title A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report
title_full A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report
title_fullStr A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report
title_full_unstemmed A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report
title_short A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report
title_sort giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221700/
https://www.ncbi.nlm.nih.gov/pubmed/30383694
http://dx.doi.org/10.1097/MD.0000000000013098
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