Moravan M J, Petraglia A L, Almast J, Yeaney G A, Miller M C, Edward Vates G
Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA.
J Neurosurg Sci. 2012 Sep;56(3):255-9.
Intraosseous hemangiomas are benign vascular tumors that are encountered most commonly in vertebrae and rarely in the skull. When presenting in the skull, they are commonly found in the calvarium in frontal and parietal bones and seldom in the skull base. We encountered a patient with an incidental finding on magnetic resonance imaging (MRI) of an enhancing lesion in the clivus. Here we report an unusual location of a clival intraosseous hemangioma. A 62 year old man worked up for carpal tunnel syndrome had imaging of his cervical spine that revealed an enhancing clival lesion, which extended into the left occipital condyle. Endoscopic endonasal biopsy was performed on the abnormality revealing a capillary hemangioma. Patient tolerated the biopsy well and no further surgical intervention is indicated at this time. Patient will be followed at six month intervals. Primary intraosseus hemangiomas of the skull are extremely rare and usually occur in the calvarium. This is one of the few reported case of an intraosseus hemangioma in the clivus. We present this case in part because it is unusual, but more importantly, with the wider use of MRI, it is likely that these lesions will be discovered more frequently, and conceivably confused for more dangerous lesions.
骨内血管瘤是一种良性血管肿瘤，最常见于脊椎，很少见于颅骨。当出现在颅骨时，它们通常位于额骨和顶骨的颅盖骨，很少见于颅底。我们遇到一名患者，在磁共振成像（MRI）检查时偶然发现斜坡有一个强化病变。在此，我们报告一例斜坡骨内血管瘤的不寻常位置。一名62岁男性因腕管综合征接受检查，其颈椎成像显示斜坡有一个强化病变，该病变延伸至左枕髁。对该异常进行了鼻内镜下活检，结果显示为毛细血管瘤。患者对活检耐受良好，目前无需进一步手术干预。患者将每六个月随访一次。颅骨原发性骨内血管瘤极为罕见，通常发生在颅盖骨。这是为数不多的几例斜坡骨内血管瘤报告病例之一。我们展示此病例部分是因为它不寻常，但更重要的是，随着MRI的更广泛应用，这些病变可能会被更频繁地发现，并且可能会与更危险的病变相混淆。
