ABSTRACT
OBJECTIVE AND IMPORTANCE: Hemangioendothelioma is an uncommon vascular neoplasm, and its intracranial occurrence is extremely rare. The occurrence of such a tumor within the cavernous sinus has not been reported previously. CLINICAL PRESENTATION: We report a 36-year-old woman who presented with right-sided retro-orbital pain and diplopia caused by a right sixth nerve paresis. Magnetic resonance imaging revealed a lesion within the right inferior cavernous sinus. INTERVENTION: The tumor was excised completely via an orbitozygomatic approach. CONCLUSION: Hemangioendothelioma is a rare, indolent vascular tumor, and its characteristics are reviewed. The need for complete excision is emphasized, and the advantages of the orbitozygomatic approach for the removal of tumors of the cavernous sinus is discussed.
Subject(s)
Brain Neoplasms/pathology , Cavernous Sinus , Hemangioendothelioma/pathology , Adult , Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Brain Neoplasms/surgery , Cavernous Sinus/pathology , Cavernous Sinus/surgery , Diagnosis, Differential , Diplopia/etiology , Female , Hemangioendothelioma/complications , Hemangioendothelioma/diagnosis , Hemangioendothelioma/surgery , Hemangioma/diagnosis , Humans , Magnetic Resonance Imaging , Meningeal Neoplasms/diagnosis , Meningioma/diagnosisABSTRACT
Spontaneous spinal epidural haematoma is an unusual but well recognized cause of compressive myelopathy or cauda equina syndrome. Radicular pain is one of the earliest symptoms and a hallmark of spontaneous spinal epidural haematoma, as in the case of cervical spondylosis and disc prolapse. Should an epidural haematoma be located in the cervical spine, the resultant cervical radicular pain may sometimes be erroneously attributed to a cardiac cause, especially in the setting of pre-existing cardiac disease. The error in diagnosis can lead to another pitfall, the addition of heparin. If the etiology of the pain is a cervical epidural haematoma this can have grave consequences. Moreover, patients with cardiac ischemia who are treated with anticoagulants may rarely develop a cervical epidural haematoma. The resulting radicular pain can overlap with cardiac pain and escape recognition. Symptoms of neck and upper extremity pain with bilateral signs of myelopathy with a sensory level should lead to a suspicion of acute cervical cord compression. The addition of heparin can only compound the disastrous consequence of a rapidly expanding spinal epidural haematoma. The following cases illustrate this diagnostic and therapeutic conundrum.
Subject(s)
Anticoagulants/adverse effects , Cauda Equina , Hematoma, Epidural, Cranial/diagnosis , Myocardial Ischemia/complications , Nerve Compression Syndromes/diagnosis , Aged , Diagnosis, Differential , Female , Hematoma, Epidural, Cranial/complications , Hematoma, Epidural, Cranial/surgery , Humans , Myocardial Ischemia/diagnosis , Myocardial Ischemia/drug therapy , Nerve Compression Syndromes/etiology , Nerve Compression Syndromes/surgeryABSTRACT
Although tuberculosis among Asian immigrants in Britain is not uncommon, intracranial tuberculomas are rare. An unusual case of a tuberculoma located in the left cavernous sinus is reported.
