Harapan Biyan Nathanael, Ruf Viktoria, Herms Jochen, Forbrig Robert, Schichor Christian, Thorsteinsdottir Jun
Department of Neurosurgery, LMU University Hospital, LMU Munich, 81377 Munich, Germany.
Faculty of Medicine, Center for Neuropathology and Prion Research, 81377 Munich, Germany.
J Clin Med. 2024 Sep 28;13(19):5813. doi: 10.3390/jcm13195813.
Venous hemangiomas within the central nervous system (CNS) represent a rare pathological entity described by sporadic case reports so far. Comprehensive insights into their histological and imaging features, pathogenesis, natural course, and therapeutic modalities are lacking. This review article presents two patients with contrast-enhancing cerebellar lesions near the tentorium cerebelli lacking edema or diffusion restriction. Despite meticulous preoperative neuroradiological examination, diagnostic classification remained inconclusive. Confronted with both-progressive size and diagnostic uncertainty-surgical intervention was undertaken, resulting in uneventful and complete resection of the lesions. Histopathological analyses subsequently revealed a venous hemangioma in each case. In the literature, the term "hemangioma" is often misapplied and inaccurately used to describe a broad spectrum of vascular anomalies. Therefore, a precise identification is essential since the particular type of vascular anomaly affects its natural course and the treatment options available. We aim to contribute to the understanding of this diagnostically intricate entity by presenting the two cases and by providing a detailed overview of radiological and histopathological features of venous hemangiomas.
中枢神经系统(CNS)内的静脉血管瘤是一种罕见的病理实体,迄今为止仅有散发病例报道。目前仍缺乏对其组织学和影像学特征、发病机制、自然病程及治疗方式的全面认识。本文报道了两例小脑幕附近增强的小脑病变患者,病变无水肿或弥散受限。尽管术前进行了细致的神经影像学检查,但诊断分类仍不明确。鉴于病变大小不断进展且诊断存在不确定性,遂采取了手术干预,病变得以顺利完整切除。随后的组织病理学分析显示,两例均为静脉血管瘤。在文献中,“血管瘤”一词常被误用,不准确地用于描述多种血管异常。因此,精确识别至关重要,因为特定类型的血管异常会影响其自然病程及可用的治疗方案。我们旨在通过展示这两个病例,并详细概述静脉血管瘤的放射学和组织病理学特征,来增进对这种诊断复杂的实体的理解。