Dural manifestation of capillary hemangiomas - a case presentation and systematic review

Dural capillary hemangiomas (CHs) are exceedingly rare benign vascular lesions, posing significant diagnostic challenges due to the absence of specific clinical or radiological features.

We report the case of an adolescent patient with symptomatic fronto-temporal dural CH and provide a comprehensive systematic review of all reported cases in the literature.

We conducted a systematic review, searching PubMed/Medline, Embase, and Web of Science using the terms "intracranial AND capillary hemangioma" and "dural AND capillary hemangioma." Only peer-reviewed English articles reporting histopathologically confirmed dural CHs were included.

The reported case was an adolescent patient with a dural lesion who underwent complete surgical resection due to suspicion of malignant pathology based on unusual clinical and radiological presentation. This lesion was consequently identified as CH on histopathological examination. In our systematic review we included 26 articles on dural CHs from the existing literature, reporting 35 cases over a period of 32 years, including our case.

Dural CHs exhibit distinct demographic patterns characterized by adult predominance and female predilection in comparison to extracranial CHs. Nonspecific imaging characteristics in CHs necessitate histopathological confirmation for definitive diagnosis. Surgical intervention has been demonstrated to yield favorable outcomes with minimal recurrence rates. Findings from this review suggest that current management may be driven more by diagnostic uncertainty and concerning presentations than by growth characteristics. Dural CHs should be considered in the differential diagnosis of contrast enhancing dural lesions, particularly in adults. Standardized documentation of future cases would facilitate better understanding of natural history and optimize management strategies for this rare entity.