Cavernous hemangiomas of the cranial vault in infants: a case-based update.
BACKGROUND
Mass lesions arising in the scalp or the cranial vault of children require a significant diagnostic work-up but their nature, in most instances, can only be clarified after histopathological study. Tumors of osseous consistency or merging from within cranial bones are seldom susceptible of fine needle aspiration biopsy and require excision. Ossified cephalhematoma is a rare entity that is usually related to perinatal or accidental trauma. Exceptionally, ossified cephalhematoma has a non-traumatic origin and arises from a different condition, as vascular tumor or malformation.


CONCLUSIONS
Cavernomas of the skull are infrequent and occur in middle-aged individuals. Skull cavernomas in infants lack the sunburst radiographic pattern seen in adults and may present as a bone-like tumor whose appearance is identical to that of ossified cephalhematoma. A literature search showed only two previous reports of patients younger than 1 year with skull cavernomas presenting with associated ossified cephalhematomas. We hypothesize that this type of skull cavernomas are congenital in origin and that they manifest precociously due to the occurrence of early bleeding.


METHODS
We report a 12-month-old boy presenting with a hard tumor arising on his right parietal bone that was present since birth. After diagnostic work-up, the bone tumor and the associated intraosseous hematoma were removed. Interestingly, the source of the hematoma was a cavernous hemangioma originating in the skull.


CONCLUSIONS
Calvarial cavernous hemangiomas may bleed precociously, even before birth, and manifest as large intraosseous hematomas. Differential diagnosis against ossified cephalhematoma can only be established through histopathological study.
Martínez-Lage
Juan F
JF
Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain. juanf.martinezlage@cablemurcia.com
Torroba
María-Amparo
MA
Cuartero Pérez
Beatriz
B
Almagro
María-José
MJ
López López-Guerrero
Antonio
A
de la Rosa
Pedro
P
D002648:Child; D002675:Child, Preschool; D020786:Hemangioma, Cavernous, Central Nervous System / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012886:Skull / Q000196:embryology / Q000473:pathology; D012888:Skull Neoplasms / Q000473:pathology*
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