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A Case of Resection of Multiple Dural Cavernous Hemangiomas Mimicking a Convexity Meningioma
Yusuke Hara1, Keisuke Miura1, Yoshifumi Okada1
1Neurosurgery, Kitahara International Hospital, Kitahara Neurosurgical Institute (KNI), Hachioji, JPN.
Abstract:
The patient was a 55-year-old woman who presented with a chief complaint of a dull headache. An MRI scan revealed three tumors in the parietal and occipital regions, near the superior sagittal sinus. The patient was observed for suspected meningioma. After six years, a slight tumor enlargement was observed on follow-up imaging, and because the patient requested treatment, surgical resection was performed. Preoperative assessment revealed no developmental venous anomalies on MRI, no hemosiderosis on T2-weighted imaging, and a dural tail sign on contrast-enhanced T1-weighted imaging. However, angiography did not detect any feeding vessels. Postoperative pathological examination of the resected tumors diagnosed them as dural cavernous hemangiomas. Based on this case, we recommend performing angiography during the preoperative assessment when meningioma of the parasagittal region is the primary differential diagnosis and considering dural cavernous hemangioma as an alternative diagnosis.
Insights
A rare case of dural cavernous hemangioma mimicking meningioma highlights the importance of preoperative angiography. This diagnostic step is crucial for parasagittal tumors, aiding in differentiating hemangiomas from meningiomas.
Area of Science:
- Neurosurgery
- Neuroradiology
- Neuropathology
Background:
- Meningiomas are common intracranial tumors, often found in the parasagittal region.
- Dural cavernous hemangiomas are rare vascular malformations that can present similarly to meningiomas.
- Accurate preoperative diagnosis is essential for appropriate surgical planning and patient management.