Jacob Chen Ming Low1, Eleni Maratos2, Atul Kumar3, Andrew King3, Safa Al-Sarraj3, Sinan Barazi2. 1. Department of Neurosurgery, King's College Hospital, London. Electronic address: Jacob.CM.Low@doctors.org.uk. 2. Department of Neurosurgery, King's College Hospital, London. 3. Department of Neuropathology, King's College Hospital, London.
Abstract
BACKGROUND: Capillary haemangiomata are benign vascular tumours that typically occur in children. They rarely occur in the central nervous system. Intracranial capillary haemangioma in adults are very rare entities with only 18 cases reported in the literature. We report a case of parasellar capillary haemangiomata that extended into the sella in a 64-year-old woman as well as a review of the literature in adults. CASE DESCRIPTION: We report a 64-year-old patient who presented with a headache, left sided paraesthesia and weakness. Initial computed tomography (CT) of her brain showed a left sided 3 cm by 2.5 cm parasellar lesion with intrasellar extension and no mass effect. Subsequent magnetic resonance imaging (MRI) showed a lesion which was homogenously hyperintense on T2-weighted MRI and FLAIR, isointense with adjacent brain parenchyma on T1-weighted MRI, and which demonstrated enhancement following contrast administration. The patient initially underwent an endoscopic transsphenoidal biopsy, which was inconclusive, followed by a craniotomy, biopsy and debulking. Histological examination showed fibrous tissue containing numerous thin walled and irregular vascular channels of varying sizes. There was a very mild associated inflammatory infiltrate, mainly formed of small mononuclear chronic inflammatory cells and occasional histiocytes. The histological appearances were in keeping with capillary haemangioma. CONCLUSION: Capillary haemangioma related to the sella are very rare and can easily be misdiagnosed on imaging alone. The present case highlights capillary haemangioma as an important, albeit rare, differential when considering a sellar or parasellar mass.
BACKGROUND:Capillary haemangiomata are benign vascular tumours that typically occur in children. They rarely occur in the central nervous system. Intracranial capillary haemangioma in adults are very rare entities with only 18 cases reported in the literature. We report a case of parasellar capillary haemangiomata that extended into the sella in a 64-year-old woman as well as a review of the literature in adults. CASE DESCRIPTION: We report a 64-year-old patient who presented with a headache, left sided paraesthesia and weakness. Initial computed tomography (CT) of her brain showed a left sided 3 cm by 2.5 cm parasellar lesion with intrasellar extension and no mass effect. Subsequent magnetic resonance imaging (MRI) showed a lesion which was homogenously hyperintense on T2-weighted MRI and FLAIR, isointense with adjacent brain parenchyma on T1-weighted MRI, and which demonstrated enhancement following contrast administration. The patient initially underwent an endoscopic transsphenoidal biopsy, which was inconclusive, followed by a craniotomy, biopsy and debulking. Histological examination showed fibrous tissue containing numerous thin walled and irregular vascular channels of varying sizes. There was a very mild associated inflammatory infiltrate, mainly formed of small mononuclear chronic inflammatory cells and occasional histiocytes. The histological appearances were in keeping with capillary haemangioma. CONCLUSION:Capillary haemangioma related to the sella are very rare and can easily be misdiagnosed on imaging alone. The present case highlights capillary haemangioma as an important, albeit rare, differential when considering a sellar or parasellar mass.