AJNR病例-March 24, 2016-Cavernous Hemangioma of the ...

病史：

An incidental finding in a 61-year-old man after head trauma

男，61岁，头颅外伤后偶然发现

作者及单位：

Carmen Ojados Hernández, Placida Alemán Díaz, M^a Francisca Cegarra Navarro
Reina Sofía University General Hospital
Murcia, Spain

图片说明：

Axial CT with bone algorithm (A) shows left frontal intraosseous expansile osteolytic lesion with thickened trabeculae. Axial (B) and sagittal (C) T1WI shows a T1-isointense enhanced bone lesion with avid enhancement after contrast administration (D). Axial T2WI (E) and T2 GRE (F) show a heterogeneous high signal.

诊断：颅骨海绵状血管瘤

Cavernous Hemangioma of the Skull

• Background:

• Intraosseous skull hemangiomas are uncommon lesions, representing 0.2% of all bone tumors.

• It occurs predominantly in women and more frequently in the fourth decade of life.

• Benign vascular neoplasms with a slow grow rate

• Clinical Presentation:

• Most often an incidental finding

• When symptomatic, may present with headache, dizziness, eye pain, and proptosis.

• Key Diagnostic Features:

• Skull radiography: A lytic lesion with esclerotic borders, 'honeycomb' apparence

• CT: The most common pattern is an expansie lesion with thin borders and intact inner and external tables

• MRI: Signal intensity depends on the amount of blood products due to venous stasis and the rate of transformation of red marrow into fatty marrrow. High T2 signal is common.

• Differential Diagnosis:  鉴别诊断

• Aneurysmal bone cyst   动脉瘤样骨囊肿

• Fibrous dysplasia          骨纤维结构不良

• Paget disease                Paget氏病

• Metastasis                     转移

• Langerhans cell histiocytosis (eosinophilic granuloma)  郎格罕细胞组织细胞增生症（嗜酸性肉芽肿）

• Angiomatous meningioma   血管瘤型脑膜瘤

• Hemangioperycitoma           血管外皮细胞瘤

• Treatment:

• Surgery may be considered when there is significant mass effect, intralesional hemorrhage, or due to aesthetic reasons.

• Tumor embolization and radioterapy are other, less frequently used therapeutic options