Skull vault hemangioma

Case contributed by Ahmed Mahrous Saied
Diagnosis almost certain

Presentation

Slowly growing swelling at the back of the head. Also, recent complain of headache.

Patient Data

Age: 55 years
Gender: Female

Skull

x-ray

Lateral skull radiograph showing a well defined expansile bony lesion with well defined margins in the occipital bone. The lesion shows multiple parallel internal trabeculations, creating a hair-on-end like appearance.    

ct

There is a well defined expanding bony lesion of the occipital bone. The lesion is inter-diploic with expansion of the inner and outer tables. The lesion shows predominantly bony matrix with multiple internal trabeculae. 

Narrow zone of transition is noted. No associated soft tissue component.

No intra-cranial extension, however there is significant mass effect. 

Case Discussion

The above features are highly suggestive of an intra-osseous hemangioma.  

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