Title

Congenital Calvarial Hemangioma

Authors

Michal Brichacek
Abdul Naeem, Western University
Guido Filler, Western UniversityFollow
Robert Hammond, Western UniversityFollow
Arjang Yazdani, Western UniversityFollow
Adrianna Ranger, Western UniversityFollow

Document Type

Article

Publication Date

9-1-2018

Journal

The Journal of Craniofacial Surgery

Volume

29

Issue

6

First Page

1625

Last Page

1628

URL with Digital Object Identifier

https://doi.org/10.1097/SCS.0000000000004613

Abstract

Objectives

The authors describe a case of congenital calvarial hemangioma successfully managed using propranolol therapy. Presenting symptoms, radiological and pathological features, differential diagnosis, and management of this rare congenital mass are described.

Case Presentation

A 2-year-old boy presented with a 1-year history of a growing right parietal skull mass. No obvious etiology was apparent. No focal neurological deficits or associated craniofacial anomalies were identified. Plain film imaging demonstrated focal thickening of the right parietal bone with internal trabeculations in a sunburst appearance. Computed tomography (CT) scan showed bone thickening with coarsening of the bony trabeculae, minor irregularity of the outer table, unaffected inner table, and no evidence of aggressive features. A diagnostic biopsy of the lesion was performed in the operating room. Microscopic examination was consistent with hemangioma. Based on histological and radiological features of the lesion, it was identified as a cavernous hemangioma. Medical treatment utilizing propranolol was initiated for over 3 years with interval reduction in the lesion size. MRI head following treatment with propranolol demonstrated reduction of the mass compared to preoperative imaging.

Conclusions

Although a rare entity, it is important to consider congenital calvarial hemangioma in the differential diagnosis of slow growing skull lesions due to the possibility of complications as a result of the hemangioma's intracranial extension, and the potential for treatment. En bloc resection has classically been described as a treatment for such lesions, although our case demonstrates that medical treatment with propranolol therapy may be appropriate in certain situations.

Notes

Article available at The Journal of Craniofacial Surgery

https://doi.org/10.1097/SCS.0000000000004613

Copyright © 2018 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.