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Hemangioma of the porus acusticus. Impact of imaging studies: case reports
M C Petit-Lacour1, K Marsot-Dupuch, M Hadj-Rabia
1Department of Neuroradiology, Kremlin-Bicêtre Hospital, France. dominique.doyon@bct.ap-hop-paris.fr
Abstract:
Hemangiomas are tumors. Hemangiomas near the geniculate ganglion or in the internal acoustic meatus are well known but rare. We present two cases of hemangiomas located at the porus acusticus, an even more rare site. MRI showed a millimeter-sized tumor, located in the porus acusticus, developing perpendicular to the axis of the acoustico-facial nerves, surrounding them. They were hyperintense on T1-weighted images, strongly hyperintense on T2-weighted images with a characteristic progressive and marked enhancement after injection of gadolinium DTPA. Similar signal abnormalities were present in the adjacent temporal bone, and CT scan demonstrated a honeycomb appearance with intratumoral bony spicules. These imaging criteria allows differentiation between hemangioma and neurinoma. We hypothesize that this location is related to the presence of a rich vascular plexus of the dura mater in this area.
Insights
Two rare hemangiomas were found at the porus acusticus, a unique tumor location. Imaging characteristics helped differentiate these vascular tumors from neurinomas.
Area of Science:
- Neurology
- Radiology
- Oncology
Background:
- Hemangiomas are benign vascular tumors.
- While hemangiomas near the geniculate ganglion or internal acoustic meatus are known, they are rare.
- The porus acusticus represents an exceptionally rare site for hemangioma development.
Observation:
- Two cases of hemangiomas at the porus acusticus are presented.
- Magnetic Resonance Imaging (MRI) revealed millimeter-sized tumors.
- These tumors were situated perpendicular to the acoustico-facial nerves, encasing them.
Findings:
- Tumors exhibited hyperintensity on T1-weighted and T2-weighted MRI sequences.
- Characteristic progressive and marked enhancement was observed post-gadolinium injection.
- Computed Tomography (CT) scans showed a honeycomb appearance with intratumoral bony spicules, aiding differentiation from neurinoma.
Implications:
- The distinct imaging findings aid in differentiating porus acusticus hemangiomas from neurinomas.
- The location may be linked to the dense dural vascular plexus in this region.
- This study highlights an extremely rare presentation of hemangiomas, expanding knowledge of their potential locations.
