title: Cranio-orbital primary intraosseous haemangioma.
abstract: OBJECTIVE
  Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date.
  
  
  METHODS
  Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described.
  
  
  RESULTS
  Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic 'honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells.
  
  
  CONCLUSIONS
  IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation.
authors.affiliation: Adnexal Department, Moorfields Eye Hospital, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Gupta
authors.forename: G E
authors.initials: GE
authors.lastname: Rose
authors.forename: M
authors.initials: M
authors.lastname: Manisali
authors.forename: P
authors.initials: P
authors.lastname: Minhas
authors.forename: J M
authors.initials: JM
authors.lastname: Uddin
authors.forename: D H
authors.initials: DH
authors.lastname: Verity
mesh_terms: D000328:Adult; D005260:Female; D006392:Hemangioma, Cavernous / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012886:Skull / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D012888:Skull Neoplasms / Q000473:pathology* / Q000601:surgery; D013131:Spine / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D054079:Vascular Malformations / Q000473:pathology* / Q000601:surgery