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Giant Calcified Cavernous Hemangioma Managed with Modified Double Concentric Craniotomy
Vikas Chandra Jha1, Vishal Abhijit1, Neera Jha1
1Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India.
Journal of Neurosciences in Rural Practice
|July 23, 2021
Summary
Giant calcified cavernous hemangioma invading the skull is rare and can mimic other tumors. A modified double concentric craniotomy successfully removed the lesion, preserving neurovascular structures.
Area of Science:
- Neurosurgery
- Neuroradiology
- Surgical Pathology
Background:
- Giant calcified cavernous hemangiomas (GCCC) are rare vascular malformations.
- Calvarial invasion with intracranial extension and dural breach is exceptionally uncommon.
- Radiological differentiation from lesions like meningioma is often challenging.
Observation:
- A 35-year-old female presented with intractable seizures due to a skull-based vascular lesion.
- Imaging revealed a hypervascular lesion mimicking intraosseous meningioma, sarcoma, or metastases.
- The lesion demonstrated calvarial invasion and intracranial extension.
Findings:
- A modified double concentric craniotomy was performed for complete tumor excision.
- Histopathology confirmed the lesion as a calcified cavernous hemangioma.
- The patient remained asymptomatic with no recurrence at 1-year follow-up.
Implications:
- Differentiating GCCC from other skull base lesions on imaging can be difficult.
- Modified double concentric craniotomy is a valuable surgical technique for complex GCCC.
- This approach effectively safeguards critical neurovascular structures during resection.
