Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 27, 2015
Cavernous Sinus Hemangioma
- Cavernous sinus hemangiomas (CSHs) are uncommon benign lesions. They account for fewer than 1% of parasellar masses, with a ratio F:M = 7:1, and are seen mainly in the fourth decade of life.
- Symptoms range from headaches and retro-orbital pain to cranial nerve palsies with ophthalmoplegia.
- Key Diagnostic Features:
- CSHs are assessed by MRI, for characterization, location, and relationship with the surrounding structures. The MR image findings are of a well-defined mass with low to isointensity on T1-weighted images, and marked hyperintense signal on T2-weighted images. CSHs show a progressive enhancement with a centripetal fill-in pattern.
- The diagnosis can be confirmed by a labeled red cell blood pool scintigraphy.
- DDx:
- Meningioma
- Chordoma
- Chondroma/chondrosarcoma
- Metastasis
- Swhwannoma
- Lymphoma
- Atypical vascular neoplasm of the cavernous sinus
- Rx: Surgery, preoperative radiation therapy — gamma knife surgery
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