Intraosseous cystic cavernous angioma with occipital skull osteolysis

Abstract

Intraosseous cavernous angiomas (CAs) of the skull are rare, and those cases that appear are commonly localized in the frontal bone. Computed tomography (CT) and Magnetic resonance imaging (MRI) typically show a well-defined intradiploic lytic mass with homogeneous enhancement. We describe an intraosseous cystic CA of the occipital skull in a 46-year-old man who presented with transient right-sided deafness and posterior cervical pain. MRI revealed a large (3.7 cm × 3.2 cm × 4.1 cm) extra-axial tumor, compressing the right cerebellar hemisphere, with heterogeneous peripheral enhancement. A CT scan showed osteolytic change of the occipital skull. The tumor was totally resected via a suboccipital approach. Intraoperatively, we found a mainly cystic tumor containing xanthochromic fluid. Histologically, the tumor was diagnosed as a cavernous angioma. This is the first reported case of an intraosseous CA of the skull with cyst formation. The characteristic radiological imaging of the presented case mimicked a malignant tumor with peripheral enhancement and prominent osteolytic change.