Skull vault hemangioma

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Left frontal swelling for 7 years. Non-tender and slowly increasing in size.

Patient Data

Age: 45 years
Gender: Male
ct
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Info

Small well-defined lesion with coarse trabeculations involving the outer table of left frontal bone measuring about 6 x 10 mm, associated with minimal swelling of the overlying soft tissues.

mri
Axial
T1
Axial
T2
Axial
T2 TIRM
Coronal T1
fat sat
Coronal T2
fat sat
Sagittal
T1
Sagittal
T1 fat sat
Sagittal T1
C+ fat sat
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Info

Small well-defined lesion involving the outer table of the left frontal bone. It is slightly hyperintense on T2 and isointense-hypointense on T1-weighted images relative to the bone marrow. It shows homogeneous enhancement on the post-contrast study. 

7 years later

ct
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Info

The lesion has mildly increased in size and now it measures 10 x 15 mm, as compared to the previous measurement of 6 x 10 mm. It is associated with mild thickening and contour bulge in the overlying galeal soft tissues. 

pathology
40x
H&E
200x
H&E
Immunostain
CD 34
Immunostain
CD 34
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Info

Capillary proliferation filling the bone trabeculae. CD34 highlights the vascular proliferation confirming the diagnosis of hemangioma. 

Case Discussion

Slowly growing small well-defined lesion involving the outer table of the left frontal bone; the differential diagnosis for this lesion includes skull vault hemangiomaosteomaeosinophilic granuloma and fibrous dysplasia

The lesion was excised.

Procedure: Curettage of left frontal bone lesion.

Diagnosis: Skull vault hemangioma

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