Intraosseous Cavernous Angioma of the Petrous Bone

ABSTRACT

Objective: Intraosseous cavernous angioma (CA) of the petrous bone is rare and preoperative diagnosis can be challenging, especially when its epicenter is outside the internal auditory canal (IAC) or geniculate ganglion. Methods: A 45-year-old man presented to our clinic with right-sided hearing loss, tinnitus, and unsteadiness. Neuroimaging revealed a right posterior petrous mass. Aggressive subtotal resection with decompression of the IAC was achieved through a right suboccipital craniotomy. Histopathological findings were consistent with CA. Conclusion: As was the case with this patient, we believe that CA should be included in the differential diagnosis of petrous region pathology with bony involvement. Surgery is warranted due to its expansive nature and to decompress the adjacent neural structures.

KEYWORDS

Angioma - cavernous - hemangioma - internal auditory canal - intraosseous - petrous

REFERENCES

• 1 Voelker J L, Stewart D H, Schochet Jr S S. Giant intracranial and extracranial cavernous malformation. Case report.  J Neurosurg. 1998;  89 465-469
• 2 Heckl S, Aschoff A, Kunze S. Cavernomas of the skull: review of the literature 1975–2000.  Neurosurg Rev. 2002;  25 56-62
• 3 Slaba S G, Karam R H, Nehme J I, Nohra G K, Hachem K S, Salloum J W. Intraosseous orbitosphenoidal cavernous angioma.  J Neurosurg. 1999;  91 1034-1036
• 4 Nakahira M, Kishimoto S, Miura T, Saito H. Intraosseous hemangioma of the vomer: a case report.  Am J Rhinol. 1997;  11 473-477
• 5 Tashiro T, Inoue Y, Nemoto Y et al.. Cavernous hemangioma of the clivus: case report and review of the literature.  AJNR Am J Neuroradiol. 1991;  12 1193-1194
• 6 Garcia-Marin V, Ravina J, Trujillo E, Gonzales-Feria L. Symptomatic cavernous hemangioma of the occipital condyle treated with methacrylate embolization.  Surg Neurol. 2001;  56 301-303
• 7 Dufour J J, Michaud L A, Mohr G, Pouliot D, Picard C. Intratemporal vascular malformations (angiomas): particular clinical features.  J Otolaryngol. 1994;  23 250-253
• 8 Mangham C A, Carberry J N, Brackmann D E. Management of intratemporal vascular tumors.  Laryngoscope. 1981;  91 867-876
• 9 Martin N, Sterkers O, Nahum H. Haemangioma of the petrous bone: MRI.  Neuroradiology. 1992;  34 420-422
• 10 Piccirillo E, Agarwal M, Rohit , Khrais T, Sanna M. Management of temporal bone hemangiomas.  Ann Otol Rhinol Laryngol. 2004;  113 431-437
• 11 Glasscock III M E, Smith P G, Schwaber M K, Nissen A J. Clinical aspects of osseous hemangioma of the skull base.  Laryngoscope. 1984;  94 869-873
• 12 Kessler L A, Lubic L G, Koskoff Y D. Epidural hemorrhage secondary to cavernous hemangioma of the petrous portion of the temporal bone.  J Neurosurg. 1957;  14 329-331
• 13 Honda M, Toda K, Baba H, Yonekura M. Congenital cavernous angioma of the temporal bone: case report.  Surg Neurol. 2003;  59 120-123