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Giant Calcified Cavernous Hemangioma Managed with Modified Double Concentric CraniotomyFunding None.
Giant calcified cavernous hemangioma is uncommon, and calvarial invasion with intracranial extension and dural breach is rare. Radiological resemblance to lesions like meningioma is unreported. Surgical excision of such lesions is technically challenging. A 35-year-old female presented with recurrent generalized tonic-clonic seizures for 2 years. Imaging suggested a highly vascular lesion arising from the skull, mimicking intraosseous meningioma, sarcoma, metastases, and so on. Double concentric craniotomy was done with lifting of bones separately around sinuses with radial cuts of dura to visualize tumor-cortical interface to safeguard neurovascular structures, and complete excision was achieved. Histopathology was suggestive of calcified cavernous hemangioma. The patient was asymptomatic at 1 year of follow-up.Differentiating angiomatous and intraosseous meningioma from calcifying giant hemangioma and other mimicking lesions may be difficult on imaging. Modified double concentric craniotomy, although used uncommonly, can be a useful technique safeguarding the neurovascular structures in its proximity.
Keywordsgiant cavernous hemangioma - intraosseous meningioma - modified double concentric craniotomy
07 May 2021 (online)
© 2021. Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
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