[CT and MRI of parasellar cavernous hemangioma in two cases]

Extracerebral cavernous hemangioma is a rare entity, only 51 cases have been reported up to 1991. Most of the extracerebral cavernous angiomas occur in the parasellar region and easily extend to the sella; with CT and MRI views entirely different from those of intracerebral cavernous hemangiomas. The CT scan shows a good, homogeneous enhanced tumor, similar to a meningioma, yet lacking calcification or bony hyperostosis. In MRI, the characteristic findings of extracerebral cavernous hemangioma are the very high signal intensity in the T2 weighted image, and strong homogeneous enhancement by Gadolinium-DTPA. Here we report two cases of parasellar cavernous hemangioma. A 68-year-old male patient shown to have a dumbbell tumor in the parasellar and sellar regions by CT scan, showed a high density before contrast, and good enhancement by an iodine contained contrast medium. The tumor had a very high signal intensity in the T2 weighted image of MRI and a good, homogeneous enhancement by Gadolinium-DTPA, yet a carotid angiogram showed it was avascular. Surgical removal was abandoned in view of the probability of massive bleeding. The second case was a 34-year-old man, who had had a skin hemangioma on the right side of the face since his childhood. For the past 3 months, he had suffered from ptosis, and limitation of eye movement which was found to be due to 3rd and 4th cranial nerve palsy. CT showed a good enhanced tumor mass in the left side of the parasellar region with sellar extension. MRI also showed a high intensity in T2WI and good, homogeneous enhancement by Gadolinium-DTPA. A carotid angiogram revealed some tumor stain. Surgical removal. in this case, was also impossible due to its intracavernous sinus location and the probability of massive bleeding.