Bird Cylaina E, Traylor Jeffrey I, Johnson Zachary D, Kim Jun, Raisanen Jack, Welch Babu G, Abdullah Kalil G
Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
Department of Neurosurgery, Westmead Hospital, Westmead, Sydney, Australia.
J Neurol Surg Rep. 2022 Jul 10;83(3):e72-e76. doi: 10.1055/s-0042-1750366. eCollection 2022 Jul.
Intraosseous hemangiomas are rare, benign tumors that can arise from the calvarium. These lesions often invade the outer table of the skull, but typically spare the inner table and intracranial structures. En bloc surgical resection is the standard treatment for intraosseous hemangiomas. However, a piecemeal resection may be required to safely remove the tumor in cases involving the inner table to protect the underlying brain parenchyma and vascular structures. Proper reconstruction is critical to optimize the cosmetic outcome, and a staged procedure allowing implantation of a custom-made implant can be considered for large lesions involving the forehead. We present a case of a patient with a large frontal intraosseous hemangioma with intradural involvement to highlight the surgical nuances of resection and review the existing literature regarding optimal management of these patients.
骨内血管瘤是一种罕见的良性肿瘤,可起源于颅骨。这些病变常侵犯颅骨外板,但通常不累及内板和颅内结构。整块手术切除是骨内血管瘤的标准治疗方法。然而,在涉及内板的病例中,可能需要分块切除以安全地切除肿瘤,以保护下方的脑实质和血管结构。适当的重建对于优化美容效果至关重要,对于涉及前额的大型病变,可考虑采用分期手术,允许植入定制的植入物。我们报告一例患有大型额骨内血管瘤并累及硬膜内的患者,以突出手术切除的细微差别,并回顾有关这些患者最佳治疗的现有文献。