CC-BY-NC-ND 4.0 · J Neurol Surg Rep 2018; 79(02): e26-e30
DOI: 10.1055/s-0038-1641731
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Hemangioma of the Cavernous Sinus: A Case Series

Dylan A. Noblett
1  Departments of Radiology, University of California, Davis Medical Center, Sacramento, California, United States
,
Jennifer Chang
1  Departments of Radiology, University of California, Davis Medical Center, Sacramento, California, United States
,
Atrin Toussi
2  Departments of Neurological Surgery, University of California, Davis Medical Center, Sacramento, California, United States
,
Arthur Dublin
1  Departments of Radiology, University of California, Davis Medical Center, Sacramento, California, United States
,
Kiarash Shahlaie
2  Departments of Neurological Surgery, University of California, Davis Medical Center, Sacramento, California, United States
› Author Affiliations
Further Information

Publication History

05 October 2017

02 March 2018

Publication Date:
26 April 2018 (online)

Abstract

Introduction Cavernous sinus hemangiomas (CSHs) are rare, vascular, extra-axial tumors that are diagnosed with a combination of imaging and biopsy. We describe the clinical presentations, imaging findings, and management of two male patients with CSHs.

Case Report Case 1 describes a 57-year-old man who presented with vision changes and cranial nerve palsies. Initial imaging and surgical biopsy were nondiagnostic. Follow-up Tc-99m tagged red blood cell (RBC) imaging supported CSH diagnosis. He was treated with surgical resection and radiotherapy.

Case 2 describes a 57-year-old man who presented with chronic headache. Imaging findings were suggestive of CSH. He underwent endoscopic endonasal surgical resection and a final diagnosis of CSH was made via biopsy.

Discussion CSHs often present with headache, vision changes, and cranial nerve palsies. Characteristic findings of a T2 hyperintense lesion with homogeneous contrast enhancement has been described in the literature. There is also a role for tagged RBC imaging studies in the setting of nondiagnostic imaging and biopsy. Surgical resection can be difficult due to tumor vascularity and encasement of internal carotid arteries. Stereotactic radiosurgery and adjuvant radiotherapy can play a role in the treatment of patients who have inoperable lesions or subtotal resections.