Liu James K, Burger Peter C, Harnsberger H Ric, Couldwell William T
Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah.
Skull Base. 2003 Nov;13(4):219-228. doi: 10.1055/s-2004-817698.
Primary intraosseous cavernous hemangiomas (PICHs) of the skull base are extremely rare tumors. These lesions are most common in the frontal and parietal bones of the calvarium. The authors describe a 40-year-old female who presented with progressive headaches. Serial imaging revealed a contrast-enhancing intraosseous lesion of the lateral body of the sphenoid bone and the greater wing associated with encroachment of the inferior cavernous sinus and mild posterior displacement of the cavernous carotid artery. Follow-up imaging 9 years later revealed slow growth of the lesion. The patient underwent complete excision of the PICH through an extradural frontopolar approach. Pathological examination revealed an intraosseous cavernous hemangioma. PICHs of the skull base can mimic other more common skull base lesions and thus can be difficult to diagnose preoperatively. Diagnosis is usually made at surgery. The authors review the literature regarding the clinical presentation, radiological characteristics, pathological features, and surgical management of PICHs.
颅底原发性骨内海绵状血管瘤（PICHs）是极为罕见的肿瘤。这些病变最常见于颅骨的额骨和顶骨。作者描述了一名40岁女性，她出现进行性头痛。系列影像学检查显示蝶骨体外侧和大翼有一个强化的骨内病变，伴有海绵窦下部受侵及海绵窦段颈内动脉轻度向后移位。9年后的随访影像学检查显示病变生长缓慢。患者通过硬膜外额极入路接受了PICH的完整切除。病理检查显示为骨内海绵状血管瘤。颅底PICHs可模仿其他更常见的颅底病变，因此术前难以诊断。诊断通常在手术时做出。作者回顾了关于PICHs的临床表现、放射学特征、病理特征及手术治疗的文献。
