Intrasellar cavernous hemangiomas: A case report with a comprehensive review of the literature
| Autor: | Zaina Brinji, Deepa Mushtaq, Waeel Hamouda, Khalid Mohammed Al-Orabi, Tahira Hamid Khalid Mohammed, Ahmed A. Farag, Sultan Ali Al-saiari, Azza Azzouz |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Case Report Radiosurgery Cavernous hemangioma Hemangioma 03 medical and health sciences 0302 clinical medicine Vascularity Pituitary adenoma Sellar medicine medicine.diagnostic_test business.industry Magnetic resonance imaging Transsphenoidal Debulking medicine.disease Radiation therapy 030220 oncology & carcinogenesis Surgery Neurology (clinical) Radiology Differential diagnosis medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2152-7806 |
| DOI: | 10.25259/sni_622_2020 |
| Popis: | Background: Extra-axial cerebral cavernous hemangiomas particularly those found in the sellar region, are extremely rare. Their clinical manifestations and imaging characteristics can mimic those of a pituitary adenoma thus making preoperative diagnosis difficult. Few cases are reported in the literature. We present a case, along with a comprehensive review of the literature regarding specific aspects of diagnosis and management of all similarly reported rare cases. Case Description: We present the clinical, radiological, and operative data of a rare case of a large intrasellar cavernous hemangioma in a 49-year-old female patient presented with headache and diminution of vision, which was diagnosed intraoperatively during an endonasal endoscopic transsphenoidal approach. Subtotal debulking was performed with immediate postoperative clinical improvement. The patient was then referred for radiotherapy and maintained her clinical improvement since then. Conclusion: Neurosurgeons should consider this rare pathology in the preoperative differential diagnosis of sellar tumors. Bright hyperintense T2 signal with or without signal voids associated with centripetal delayed contrast enhancement in magnetic resonance imaging images might raise the suspicion which can be further confirmed intraoperatively with frozen sections. Due the reported high vascularity and intraoperative profuse bleeding leading to high operative morbidities, piecemeal subtotal resection followed by radiosurgery may be considered today as the safest and most effective strategy. |
| Databáze: | OpenAIRE |
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