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Documented growth of an intracranial capillary hemangioma: A case report
Abigale D MacLellan1, Alexander S Easton1,2, Rufus Alubankudi1
1Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Intracranial capillary hemangiomas are rare in adults. This case documents the two-year growth of a rare brain capillary hemangioma in an elderly male, aiding diagnosis and treatment.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- Intracranial capillary hemangiomas are uncommon in adults, posing diagnostic challenges.
- Diagnosis is often delayed due to lack of presymptomatic imaging, limiting understanding of tumor growth.
- Capillary hemangiomas are more frequently observed in pediatric populations.
Observation:
- A 64-year-old male with a history of Lyme disease presented with confusion and exhaustion.
- Imaging revealed an intra-axial lesion in the right temporal lobe, initially suspected to be a glioma.
- A lesion noted two years prior in the same location had significantly grown.
Findings:
- Surgical resection of the lesion was performed.
- Histopathological analysis confirmed a capillary hemangioma, excluding glioma, other vascular neoplasms, or neuroborreliosis.
- The patient's confusion resolved post-operatively.
Implications:
- This case provides valuable insight into the growth rate of intracranial capillary hemangiomas in adults over a two-year period.
- Highlights the importance of serial imaging for diagnosing and monitoring rare intracranial vascular lesions.
- Contributes to the understanding of rare brain tumors in the adult population.
Abstract:
Intracranial capillary hemangiomas in adults are rare, and diagnosis can be challenging. Hemangiomas, in general (and particularly in the skin), are more often noted in the pediatric population. Due to the lack of imaging undertaken in the presymptomatic phase, the literature provides few clues on the rate of growth of these unusual tumors. Therefore, we report a case of a 64-year-old man with a medical history of Lyme disease who presented with exhaustion and confusion. Imaging demonstrated an intra-axial lesion with vascularity in the posterior right temporal lobe, raising the possibility of a glioma. Imaging two years prior revealed a very small lesion in the same location. The patient underwent a craniectomy, total resection of the lesion was completed, and his symptoms of confusion resolved. Biopsy revealed a capillary hemangioma composed of small vascular channels lined by endothelial cells and pericytes without smooth muscle. Features of glioma, vascular neoplasms or neuroborreliosis (cerebral Lyme disease) were not identified. Our case documents the growth over two years of a rare intracranial capillary hemangioma in an older adult male.
