Intraosseous hemangioma in parietal bone

A 35-year-old woman, with headaches for 6 years, was admitted to our Department of Neurology. X-ray showed an osteolytic lesion in the parietal bone, suggesting the presence of hemangioma. CT and MRI (figure) confirmed the tumor, of honeycomb-like internal structure, pressing the adjacent cortex. Neurosurgery of the tumor involved total resection and cranioplasty; the brain compression resolved and the headaches improved. Immunohistochemical examination revealed the presence of endothelial cells expressing CD34 and vimentin.

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Figure. Lateral X-ray of the skull (A), CT of the head with bone window (B), and cerebral window (C) show large inhomogeneous lesion of honeycomb appearance in the anterior part of the left parietal bone with intracranial extension. MR postcontrast T1-weighted images in the coronal (D) and sagittal (E) planes provide good visualization of the compression of the brain by the bone lesion, slightly enhanced after contrast medium injection. Follow-up CT scan with bone window (F) shows postoperative bone defect with no hematoma visible and no compression of the brain.

This case is representative of 0.2% of benign cranium tumors occurring more often in women and with no chromosomal disturbances and no specific neurologic symptoms.^1,2

1. Wyke BD. Primary hemangioma of the skull: a rare cranial tumor. AJR Am J Roentgenol 1946;61:302–316.OpenUrl

2. Politi M, Romeike BF, Papanagiotou P, et al. Intraosseous hemangioma of the skull with dural tail sign: radiologic features with pathologic correlation. AJNR Am J Neuroradiol 2005;26:2049–2052.OpenUrlAbstract/FREE Full Text