• World Neurosurg · Apr 2019

    Adult parasellar capillary haemangioma with intrasellar extension.

    • LowJacob Chen MingJCMDepartment of Neurosurgery, King's College Hospital, London, United Kingdom. Electronic address: Jacob.CM.Low@doctors.org.uk., Eleni Maratos, Atul Kumar, Andrew King, Safa Al-Sarraj, and Sinan Barazi.
    • Department of Neurosurgery, King's College Hospital, London, United Kingdom. Electronic address: Jacob.CM.Low@doctors.org.uk.
    • World Neurosurg. 2019 Apr 1; 124: 184191184-191.

    BackgroundCapillary hemangiomata are benign vascular tumors that typically occur in children. They rarely occur in the central nervous system. Intracranial capillary hemangiomata in adults are very rare entities with only 18 cases reported in the literature. We report a case of parasellar capillary hemangiomata that extended into the sella in a 64-year-old woman as well as a review of the literature in adults.Case DescriptionWe report a 64-year-old patient who presented with a headache, left-sided paresthesia, and weakness. Initial computed tomography of her brain showed a left-sided 3 cm × 2.5 cm parasellar lesion with intrasellar extension and no mass effect. Subsequent magnetic resonance imaging (MRI) showed a lesion that was homogenously hyperintense on T2-weighted MRI and fluid-attenuated inversion recovery, isointense with adjacent brain parenchyma on T1-weighted MRI, and which demonstrated enhancement after contrast administration. The patient initially underwent an endoscopic transsphenoidal biopsy, which was inconclusive, followed by a craniotomy, biopsy, and debulking. Histologic examination showed fibrous tissue containing numerous thin-walled and irregular vascular channels of varying sizes. There was a very mild associated inflammatory infiltrate, mainly formed of small mononuclear chronic inflammatory cells and occasional histiocytes. The histologic appearances were in keeping with capillary hemangiomata.ConclusionsCapillary hemangiomata related to the sella are very rare and can easily be misdiagnosed on imaging alone. The present case highlights capillary hemangiomata as an important, albeit rare, differential when considering a sellar or parasellar mass.Copyright © 2019 Elsevier Inc. All rights reserved.

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