Hemangiomas cavernosos do cranio: aspectos clinicos, radiologicos e terapeuticos

Kirchhoff, D.; Agnoli, A. L.; Eggert, H.

doi:10.1590/S0004-282X1977000400002

Resumos

São discutidos os aspectos relativos ao diagnóstico e tratamento dos hemangiomas cavernosos do crânio. Os dados obtidos em 26 casos, são apresentados, sendo salientado que a localização dos hemangiomas foi maior na região frontal, sendo mais atingido o sexo masculino. Os outros aspectos são coincidentes com os demais autores. A problemática desses tumores, principalmente a sua demonstração radiológica e o seu tratamento, são ressaltados, chegando-se à conclusão final de que o melhor meio de demonstração radiológica é a punção para contrastação direta do tumor. O tratamento de escolha é o cirúrgico, sendo a extirpação em bloco preferida nos casos de comprometimento ósseo importante, sendo a intervenção direta com dissecção e excisão reservada para as localizações nos tecidos moles ou com mínima participação óssea.

A series of 26 cases of hemangioma of the skull and review the literature are reported. The frontal localization was most frequent, contrary to the data of the literature suggesting the predominance of the parietal localization. The reported predominance of females has not been confirmed. In the present series the relation of males to females was 17:9. The radiological findings and treatment of hemangiomas are discussed. Direct puncture and injection of contrst medium is the best method for the visualization of the tumor. Treatment should be surgical consisting of total extirpation of the tumor with a margin of the healthy tissues. Direct extirpation is indicated only when soft-tissues are involved and there is no bone lesion. The en-bloque method is the technique of choice.

Hemangiomas cavernosos do cranio: aspectos clinicos, radiologicos e terapeuticos

Cavernous hemangioma of the cranial vault: clinical, radiological and therapeutic aspects

D. Kirchhoff^I; A. L. Agnoli^II; H. Eggert^I

^IAssistentes; Clinica Neurocirúgirca de Giessen, Alemanha

^IIChefe da secção de Neuroradiologia. Clinica Neurocirúgirca de Giessen, Alemanha

RESUMO

São discutidos os aspectos relativos ao diagnóstico e tratamento dos hemangiomas cavernosos do crânio. Os dados obtidos em 26 casos, são apresentados, sendo salientado que a localização dos hemangiomas foi maior na região frontal, sendo mais atingido o sexo masculino. Os outros aspectos são coincidentes com os demais autores. A problemática desses tumores, principalmente a sua demonstração radiológica e o seu tratamento, são ressaltados, chegando-se à conclusão final de que o melhor meio de demonstração radiológica é a punção para contrastação direta do tumor. O tratamento de escolha é o cirúrgico, sendo a extirpação em bloco preferida nos casos de comprometimento ósseo importante, sendo a intervenção direta com dissecção e excisão reservada para as localizações nos tecidos moles ou com mínima participação óssea.

SUMMARY

A series of 26 cases of hemangioma of the skull and review the literature are reported. The frontal localization was most frequent, contrary to the data of the literature suggesting the predominance of the parietal localization. The reported predominance of females has not been confirmed. In the present series the relation of males to females was 17:9. The radiological findings and treatment of hemangiomas are discussed. Direct puncture and injection of contrst medium is the best method for the visualization of the tumor. Treatment should be surgical consisting of total extirpation of the tumor with a margin of the healthy tissues. Direct extirpation is indicated only when soft-tissues are involved and there is no bone lesion. The en-bloque method is the technique of choice.

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Zentrum für Neurochirurgie der Justus-Liebig Universität Giessen - Klinikstrasse 37 - 68 Giessen - Deutschland.

1. ABBOT, W. D. - Angioma of the skull. An. Surg. 106:1100, 1937.
2. ABBOT, W. D. - Angioma of the skull. An. Surg. 113:306, 1941.
3. AGNOLI, A.; KIRCHHOFF, D. & EGGERT. H. - Zur Hamodynamik der angiographisch nachweisbaren Blutversorgung kavernoser Angiome der Schälelweichteile. Röfo 121_:617, 1974.
4. BEAU, H.; ROUQUES, L. & GERARD, P. L. - L'angione du rocher et son aspect radiographique. Prèsse Médicale 58:1141, 1950.
5. BERGSTRAND, ch.: OLIVECRONA, ch. & TÖNNIS, W. - Gefässmlssbildungen und Gefässgeschwülste des Gehirnes. Georg Thieme, Leipzig, 1936.
6. BUCY, P. C. & CAPP, C. S. - Primary hemangioma of bone with special reference to roentgenologic diagnosis. Amer. J. Roentgenol. 23:1, 1930.
7. CANCELLA D'ABREU, E. M. & D'OLIVEIRA, C. - Aspect a l'epreuve encephalografique des angiomas artériels du cerveau dans le domaine de la carótide interne. Rev. Neurol. (Paris) 2:165, 1932.
8. CHOUX, M.; GOMES, A.; CHOUX, R. & VIGOUROUX, R. P. - Diagnostic and therapeutic problems concerning tumors of the vault. Child's Brain 1:207, 1975.
9. CHRISTENSEN, F. C. - Bone tumors: analysis of one thousand cases with special reference to location, age and sex. An. Surg. 81:1074, 1925.
10. COURVILLE, C. B.; VOGEL, P. J. & MURIETTA, A. J. - Angiomas of the cranial vault. Bull. Los Angeles neurol. Soc. 13:1, 1948.
11. CUSHING, H. - Surgical results in general: with a case of cavernous haemangioma in particular. Surg. Gynecol, a. Obstetr. 36:303, 1923.
12. ERÖS, G. - Multiples hämangiom des Schädelknoches. Zbl. Path. 43:532, 1928.
13. GESCHICKTER, C. F. - Bone tumors. Amer. J. Roentgenol. 34:1, 1935.
14. GESCHICKTER, C. F. & COPELAN, M. M. - Tumors of Bone. J. B. Lippingceot Co. London, 1949.
15. HALTER, K. - Benigne und maligne Hauttumoren. In Lehrbuch der Haut und Geschlechtskrankheit. Georg Thieme, Stuttgart, 1962.
16. HITZROT, J. M. - Hemangioma cavernosum of bone. Ann. Surg. 65:476. 1917.
17. HUBER, P. - Gefässmissbildungen und Gefässtumoren der A. carotis externa und der Dura. Forschr. Roentgenstr. 109:325, 1968.
18. ILIFF, C. E. - Tumors of the orbit. Trans. Amer. Ophthal. Soc. 55:505, 1958.
19. IRGENS, E. R., WATERVILLE & MAINE - Hemangioma of skull involving right petrous and occipital bones. Arch. Otolaryng. 29:709, 1939.
20. ISFORT, A. - Zur Behandlung der extrakraniellen Angiome. Der Chirurg 10:433, 1962.
21. JONUTIS, A. J.; SONDHEIMER, F. K.; KLEIN, H. S. & WISE, B. L. - Intracerebral cavernous hemangioma with angiographically demonstrated pathologic vasculature. Neuroradiol. 3:57, 1971.
22. KAPLAN, A. & KANZER, M. - Sunray hemangioma of the skull. Arch. Surg. (Chicago) 39:269, 1939.
23. KESSLER, L. A.; LUBIC, L. G. & KOSKOFF, Y. D. - Epidural hemorrage secondary to cavernous hemangioma of the petrous portion of the temporal bone, J. Neurosurg. 14:329, 1957.
24. KLEINSASSER, O. & ALBRECHT, H. -- Die Hämangiome und Osteohämangiome der Schädelknochen. Langenbecks Arch. Dtsch. Z. Chir. 285:115, 1957.
25. KRAYENBÜHL, H. - Diagnostik value of orbital angiographie. Brit. J. Ophthal. 42:180, 1958.
26. KRAYENBÜHL, ch. - The value of orbital angiographie for diagnosis of unilateral exophthalmus. J. Neurosurg. 29:289, 1962.
27. McCORMICK, W. F. - The pathology of vascular (arteriovenous) malformations. J. Neurosurg. 24:897, 1966.
28. NÖDL, F. - Gutartige Neubildungen der Haut in Dermatologie und Venerologie. Georg Thieme Verlag, Stuttgart, 1960.
29. PASZTOR, E.; SZABO, G.; SLOWIK, F. & ZOLTAN, G. - Cavernous hemangioma of the base of the skull. J. Neurosurg. 21:582, 1964.
30. PÖSCHL, M. - Skelettveränderungen am Schädel bei kavernösen Gefässgeschwülsten. Röfo 84:209, 1956.
31. RUSSELL, D. S. & RUBINSTEIN, L. J. - Pathology of Tumors of the Nervous System. Edward Arnold, London, 1959.
32. SCHNEIDER, R. C. & LISS, L. - Cavernous hemangiomas of the cerebral hemispheres. J. Neurosurg. 15:392, 1958.
33. SCHÖNE, G. - Über einen Fall von myelogenem Hämangiom des Os occipitale. Beitr. path. Anat. Allg. Path., 7:685, 1905.
34. TÖNNIS, W. - Die Erkennung und Behandlung der intarkraniellen Gefässgeschwülste und Gefässmissbildungen. Arch. Klin. Chir. 180:424, 1934.
35. TÖNNIS, W. & LANGE-COSAK, H. - Klinik und operative Behandlung und Prognose der arteriovenösen Angiome des Gehirnes und seiner Häute. Dtsch. Z. Nervenheilk. 170:460, 1953.
36. TÖPFER, D. - Über ein infiltrierend wachsendes Hämangiom der Haut und multiple Capillarektasien der Haut und inneren Organe: zur Kenntnis der Wirbelangiome. Frankf. Z. Path. 36:337, 1928.
37. TOYNBEE, J. - An account of two vascular tumors developed in the substance of bone. Lancet 2:676, 1845.
38. VOGELSANG, H. - Die arteriovenösen Angiome im extrakraniellen Carotis - und Vertebralisbereich. Dtsch. Z. Nervenheilk. 184_:83, 1962.
39. VOGELSANG, H. - Probleme in der Erkennung und Behandlung ausgedehnter Schädeldachhämangiome mit extraossären Wachstum. Acta Neurochir. 2:125, 1963.
40. VOGELSANG, H. - Zur angiographische Diagnostik kavernöser Hamangiome der Kopfhaut. Röfo. 110:683, 1969.
41. VOIGT, K. & YASARGIL, M. G. - Cerebral cavernous haemangiomas or cavernomas. Neurochirurgia 19:59, 1976.
42. WYKE, B. D. - Primary hemangioma of the skull: a rare cranial tumor. Radiol. 61:302, 1949.

Datas de Publicação

Publicação nesta coleção
30 Ago 2012
Data do Fascículo
Dez 1977

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ABBOT, W. D. - Angioma of the skull. An. Surg. 106:1100, 1937.

[2] 2. ABBOT, W. D. - Angioma of the skull. An. Surg. 113:306, 1941.

[3] 3. AGNOLI, A.; KIRCHHOFF, D. & EGGERT. H. - Zur Hamodynamik der angiographisch nachweisbaren Blutversorgung kavernoser Angiome der Schälelweichteile. Röfo 121_:617, 1974.

[4] 4. BEAU, H.; ROUQUES, L. & GERARD, P. L. - L'angione du rocher et son aspect radiographique. Prèsse Médicale 58:1141, 1950.

[5] 5. BERGSTRAND, ch.: OLIVECRONA, ch. & TÖNNIS, W. - Gefässmlssbildungen und Gefässgeschwülste des Gehirnes. Georg Thieme, Leipzig, 1936.

[6] 6. BUCY, P. C. & CAPP, C. S. - Primary hemangioma of bone with special reference to roentgenologic diagnosis. Amer. J. Roentgenol. 23:1, 1930.

[7] 7. CANCELLA D'ABREU, E. M. & D'OLIVEIRA, C. - Aspect a l'epreuve encephalografique des angiomas artériels du cerveau dans le domaine de la carótide interne. Rev. Neurol. (Paris) 2:165, 1932.

[8] 8. CHOUX, M.; GOMES, A.; CHOUX, R. & VIGOUROUX, R. P. - Diagnostic and therapeutic problems concerning tumors of the vault. Child's Brain 1:207, 1975.

[9] 9. CHRISTENSEN, F. C. - Bone tumors: analysis of one thousand cases with special reference to location, age and sex. An. Surg. 81:1074, 1925.

[10] 10. COURVILLE, C. B.; VOGEL, P. J. & MURIETTA, A. J. - Angiomas of the cranial vault. Bull. Los Angeles neurol. Soc. 13:1, 1948.

[11] 11. CUSHING, H. - Surgical results in general: with a case of cavernous haemangioma in particular. Surg. Gynecol, a. Obstetr. 36:303, 1923.

[12] 12. ERÖS, G. - Multiples hämangiom des Schädelknoches. Zbl. Path. 43:532, 1928.

[13] 13. GESCHICKTER, C. F. - Bone tumors. Amer. J. Roentgenol. 34:1, 1935.

[14] 14. GESCHICKTER, C. F. & COPELAN, M. M. - Tumors of Bone. J. B. Lippingceot Co. London, 1949.

[15] 15. HALTER, K. - Benigne und maligne Hauttumoren. In Lehrbuch der Haut und Geschlechtskrankheit. Georg Thieme, Stuttgart, 1962.

[16] 16. HITZROT, J. M. - Hemangioma cavernosum of bone. Ann. Surg. 65:476. 1917.

[17] 17. HUBER, P. - Gefässmissbildungen und Gefässtumoren der A. carotis externa und der Dura. Forschr. Roentgenstr. 109:325, 1968.

[18] 18. ILIFF, C. E. - Tumors of the orbit. Trans. Amer. Ophthal. Soc. 55:505, 1958.

[19] 19. IRGENS, E. R., WATERVILLE & MAINE - Hemangioma of skull involving right petrous and occipital bones. Arch. Otolaryng. 29:709, 1939.

[20] 20. ISFORT, A. - Zur Behandlung der extrakraniellen Angiome. Der Chirurg 10:433, 1962.

[21] 21. JONUTIS, A. J.; SONDHEIMER, F. K.; KLEIN, H. S. & WISE, B. L. - Intracerebral cavernous hemangioma with angiographically demonstrated pathologic vasculature. Neuroradiol. 3:57, 1971.

[22] 22. KAPLAN, A. & KANZER, M. - Sunray hemangioma of the skull. Arch. Surg. (Chicago) 39:269, 1939.

[23] 23. KESSLER, L. A.; LUBIC, L. G. & KOSKOFF, Y. D. - Epidural hemorrage secondary to cavernous hemangioma of the petrous portion of the temporal bone, J. Neurosurg. 14:329, 1957.

[24] 24. KLEINSASSER, O. & ALBRECHT, H. -- Die Hämangiome und Osteohämangiome der Schädelknochen. Langenbecks Arch. Dtsch. Z. Chir. 285:115, 1957.

[25] 25. KRAYENBÜHL, H. - Diagnostik value of orbital angiographie. Brit. J. Ophthal. 42:180, 1958.

[26] 26. KRAYENBÜHL, ch. - The value of orbital angiographie for diagnosis of unilateral exophthalmus. J. Neurosurg. 29:289, 1962.

[27] 27. McCORMICK, W. F. - The pathology of vascular (arteriovenous) malformations. J. Neurosurg. 24:897, 1966.

[28] 28. NÖDL, F. - Gutartige Neubildungen der Haut in Dermatologie und Venerologie. Georg Thieme Verlag, Stuttgart, 1960.

[29] 29. PASZTOR, E.; SZABO, G.; SLOWIK, F. & ZOLTAN, G. - Cavernous hemangioma of the base of the skull. J. Neurosurg. 21:582, 1964.

[30] 30. PÖSCHL, M. - Skelettveränderungen am Schädel bei kavernösen Gefässgeschwülsten. Röfo 84:209, 1956.

[31] 31. RUSSELL, D. S. & RUBINSTEIN, L. J. - Pathology of Tumors of the Nervous System. Edward Arnold, London, 1959.

[32] 32. SCHNEIDER, R. C. & LISS, L. - Cavernous hemangiomas of the cerebral hemispheres. J. Neurosurg. 15:392, 1958.

[33] 33. SCHÖNE, G. - Über einen Fall von myelogenem Hämangiom des Os occipitale. Beitr. path. Anat. Allg. Path., 7:685, 1905.

[34] 34. TÖNNIS, W. - Die Erkennung und Behandlung der intarkraniellen Gefässgeschwülste und Gefässmissbildungen. Arch. Klin. Chir. 180:424, 1934.

[35] 35. TÖNNIS, W. & LANGE-COSAK, H. - Klinik und operative Behandlung und Prognose der arteriovenösen Angiome des Gehirnes und seiner Häute. Dtsch. Z. Nervenheilk. 170:460, 1953.

[36] 36. TÖPFER, D. - Über ein infiltrierend wachsendes Hämangiom der Haut und multiple Capillarektasien der Haut und inneren Organe: zur Kenntnis der Wirbelangiome. Frankf. Z. Path. 36:337, 1928.

[37] 37. TOYNBEE, J. - An account of two vascular tumors developed in the substance of bone. Lancet 2:676, 1845.

[38] 38. VOGELSANG, H. - Die arteriovenösen Angiome im extrakraniellen Carotis - und Vertebralisbereich. Dtsch. Z. Nervenheilk. 184_:83, 1962.

[39] 39. VOGELSANG, H. - Probleme in der Erkennung und Behandlung ausgedehnter Schädeldachhämangiome mit extraossären Wachstum. Acta Neurochir. 2:125, 1963.

[40] 40. VOGELSANG, H. - Zur angiographische Diagnostik kavernöser Hamangiome der Kopfhaut. Röfo. 110:683, 1969.

[41] 41. VOIGT, K. & YASARGIL, M. G. - Cerebral cavernous haemangiomas or cavernomas. Neurochirurgia 19:59, 1976.

[42] 42. WYKE, B. D. - Primary hemangioma of the skull: a rare cranial tumor. Radiol. 61:302, 1949.

Brasil

Brasil

Hemangiomas cavernosos do cranio: aspectos clinicos, radiologicos e terapeuticos

Cavernous hemangioma of the cranial vault: clinical, radiological and therapeutic aspects

Resumos

Datas de Publicação