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Published on: October 20, 2017
GIANT CAVERNOUS MALFORMATION WITH UNUSUALLY AGGRESSIVE CLINICAL COURSE: A CASE REPORT
Jovan Grujić1, Vladimir Jovanović1, Goran Tasić1
11Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; 3Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia; 4School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5University of Applied Health Sciences, Zagreb, Croatia.
Giant cavernomas (GC) are rare brain lesions. This case highlights the importance of considering GC in young patients with large hemorrhagic brain lesions, even with significant mass effect.
Area of Science:
- Neurosurgery
- Neuropathology
- Neuroradiology
Background:
- Giant cavernomas (GC) are rare vascular malformations, with fewer than 50 cases reported globally.
- Clinical manifestations typically include epileptic seizures or focal neurological deficits secondary to hemorrhage and mass effect.
Observation:
- A 17-year-old male presented with acute onset of severe headache, right-sided hemiparesis, and speech difficulties.
- Emergency CT revealed a large, heterogeneous left frontal lesion with significant mass effect.
- The patient's condition rapidly deteriorated, necessitating emergency surgical resection.
Findings:
- Macroscopic examination suggested melanoma metastasis, but histopathology confirmed a cavernoma.
- This case underscores the diagnostic challenges posed by the variable imaging appearance of GCs.
Implications:
- Giant cavernomas should be included in the differential diagnosis of large hemorrhagic brain lesions, particularly in pediatric and young adult populations.
- While emergency surgery is sometimes required, bleeding cavernomas are often managed electively due to specific surgical considerations and potential complications.
